Detection of the JAK2 Gene Mutation in Familial Myeloproliferative Disorders and Significance in Chinese Peoples

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5263-5263
Author(s):  
Ru Feng ◽  
Yongmin Zhang ◽  
Yongqiang Wei ◽  
Yu Zhan

Abstract Myeloproliferative disorders (MPDs) constitute a group of hematopoietic malignancies. Most of the MPD patient are sporadic and there are seldom reports in familial MPD. Present studies indicated that the excessus activation of signal transduction pathway of protein tyrosine kinase is an important factor in the pathogenesy of MPD. At present, except the CML, the other kinds of Ph-negative MPD are still unclear for pathogenesis. A new acquired mutation-JAK2V617F on JAK2 gene has been discovered successively in most of PV and in part of ET and IMF patient by scholars. Studies also discover that JAK2V617F mutation exists not only in the sporadic MPD but also in the familial MPD. Now only a few of studies has focus on the familial MPD abroad, and no report about JAK2V617F mutation in familial MPD chinese poeple. Methods: We mainly collected peripheral blood sample from the family members including the two MPD patients, then we took a routine blood count test and flow cytometry analysis (including CD34, CD41, CD61, CD71, CD117, GPA. Inspection of the BM smear and pathology of BM biopsy is taken when is necessary. we collected all the nucleated cells from the peripheral blood sample and then the DNA from the nucleated cells were extracted. We design a specific primer which is specific for codon V617 of the JAK2 gene according to the reference, and then amplify the target gene by PCR and confirm the PCR product by the way of electrophoresis, we use the restriction enzyme to digest the PCR product after purification. We detect another acquired functionality gene mutation (MPLW515L/K) to the ET and IMF patient who are JAK2V617F negative by the way of PCR and DNA sequencing. we also evaluated the specific markers that had been found in familial ET such as TPO and c-mpl gene mutation by the way of DNA sequence analysis for all of the member in the family, especially the ET patient and his children. An research to detect the EPOR gene mutation on the family members especially for the PV patient and his children was carried. Results: In summary, we found that many of the members are abnormal in routine blood test besides the two MPD patient, and some of them surpass the normal level. Of the member whose PLT count is much higher than normal count was also found abnormal in cell surface antigen expression, and we diagnosis it as the third MPD(ET) patient in this family combining with the result of BM cell morphologyand pathology of BM biopsy. There were total three members carried the JAK2V617F mutation in this family, including the two MPD patient and the father whose WBC count is higher than normal but without any clinical manifestation. We also found that all members who carried the JAK2V617F mutation are male, and affected in two generation of the family. Another female member whose PLT count is obviously higher than normal with JAK2V617F negative was diagnosised as JAK2V617F negative ET. Other common markers of MPD such as MPLW515L/K in JAK2V617F negative ET and TPO, c-mpl gene mutation in familial ET and EPOR gene in familial erythrocytosis could not being found in this family. Conclusion: According to the results of our study, we found that an hereditary susceptibility may exits in this family which make the members in the family easier to development into MPD, and it is necessary to take carry an regular blood routine test and other related inspection for the family member. Our study hold on an investigation and an research in a familial MPD member for reach a goal of better understanding about JAK2V617F mutation frequency and Other common markers of MPD(sporadic MPD but also familial MPD) such as MPLW515L/K, TPO, c-mp, EPOR in this family and the role of those mutation in the pathogenesy in familial MPD, we provide some theory basis to further expounding of the pathogenesis and treatment in Ph- MPD, specially in discovering, diagnosis and prevention for the disease at a early stage. No research about the JAK2V617F mutation in familial MPD at present in chinese people, Therefore, our research is in advanced in domestic study.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5056-5056
Author(s):  
Ru Feng ◽  
Lixia Hao ◽  
Yongmin Zhang ◽  
Yongqiang Wei ◽  
Fen Huang ◽  
...  

Abstract Abstract 5056 Introduction: JAK2V617F point mutation have been confirmed to be one of the major molecular mechanism of BCR/ABL negative myeloproliferative disorders(MPD). Besides, some other gene mutations such as JAK2 exon12, MPL W515L/K, c-mpl and EPOR have extended the scope of the research in this field. Most of the MPD patients are sporadic and there are seldom reports in Chinese familial MPD. 2008 ASH metting we have reported in a Chinese family of MPD's findings, the two brothers in our hospital diagnosis for MPD (one is a PV, another is ET), then we investigated the 15 members of the family. We discovered that there were three male members carried the JAK2V617F mutation in this family, including the two MPD patients and their father, which affected in two generations. All the family members were confirmed as BCR/ABL, MPL W515L/K, c-mpl, and EPOR negative. Subsequently, in order to understand the existence of family members in addition to the gene JAK2 V617F mutation, the existence of JAK2 gene mutations in other parts of the? if other mutations in existence and the high incidence of family members of MPD? We focus on the cDNA full-length of JAK2 gene to provide some theory basis on the pathogenesis in MPD. Methods: A total of 15 family members were enrolled in our study, including 2 brothers of MPD patients (the older one was thrombocythemia (ET), and another is polycythemia vera (PV)) and the other members in the same family. The mRNA of mononuclear cells from peripheral blood sample was extracted according to the manufacturer's instruction (TAKARA). RT-PCR and DNA sequencing have been used to analyze the cDNA full-length of the JAK2 gene. Results: All of the samples can be analyzed for JAK2 cDNA full-length. 3 members carried the JAK2V617F mutation (1849G®T) in this family, including the two MPD patients and their father. And the older brother was homozygous mutation and the other two were heterozygous mutation. All of the 15 samples were JAK2 exon12 gene mutation negative. 2 persons who were the male ET patient's children had a heterozygous mutation (380G®A) in JAK2 exon 3, caused a glycine-to-asparticacid substitution at position 127. Besides, 13 persons had 489C®T mutation in exon 4 and 14 persons had 2490G→A mutation in exon 17 in this family, But they were both same-sense mutation. Conclusion: It is necessary to do routine analysis of blood and other related inspection for MPD patient's family members, so as to make diagnosis earlier. However, we are not sure that the sequencing results are unique to all the familial MPD and need to be confirmed by more cases. We still do not determine the current discovery point mutations have biological significance, still need to be further explored. Disclosures: No relevant conflicts of interest to declare.


2007 ◽  
Vol 45 (1) ◽  
pp. 220
Author(s):  
T. Aper ◽  
A. Schmidt ◽  
M. Duchrow ◽  
H.-P. Bruch

1991 ◽  
Vol 23 (2) ◽  
pp. 95-107 ◽  
Author(s):  
Lawrence G. Calhoun ◽  
Breon G. Allen

This article reviews the available literature on reactions to family members surviving another member's suicide. Three factors determining the reaction of others to persons bereaved by suicide are investigated: 1) the cause of death, 2) characteristics of the deceased, and 3) characteristics of the respondent. The perceptions that persons bereaved by suicide have of the way others view them are reviewed. Methodological flaws and limitations of the current research are noted, with suggestions for the direction of future research. Tentative generalizations and suggestions for clinical practice are also made.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Hao Geng ◽  
Dongdong Tang ◽  
Chuan Xu ◽  
Xiaojin He ◽  
Zhiguo Zhang

Background. Split-hand/foot malformation (SHFM) is a severe congenital disability mainly characterized by the absence or hypoplasia of the central ray of the hand/foot. To date, several candidate genes associated with SHFM have been identified, including TP63, DLX5, DLX6, FGFR1, and WNT10B. Herein, we report a novel variant of TP63 heterozygously present in affected members of a family with SHFM. Methods. This study investigated a Chinese family, in which the proband and his son suffered from SHFM. The peripheral blood sample of the proband was used to perform whole-exome sequencing (WES) to explore the possible genetic causes of this disease. Postsequencing bioinformatic analyses and Sanger sequencing were conducted to verify the identified variants and parental origins on all family members in the pedigree. Results. By postsequencing bioinformatic analyses and Sanger sequencing, we identified a novel missense variant (NM_003722.4:c.948G>A; p.Met316Ile) of TP63 in this family that results in a substitution of methionine with isoleucine, which is probably associated with the occurrence of SHFM. Conclusion. A novel missense variant (NM_003722.4:c.948G>A; p.Met316Ile) of TP63 in SHFM was thus identified, which may enlarge the spectrum of known TP63 variants and also provide new approaches for genetic counselling of families with SHFM.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 434-434
Author(s):  
Nicholas C Lea ◽  
Lara N Roberts ◽  
Raj K Patel ◽  
Rachel Westbrook ◽  
Michael A Heneghan ◽  
...  

Abstract Abstract 434 Budd-Chiari Syndrome (BCS) is a group of disorders resulting from obstruction to hepatic venous outflow; myeloproliferative disorder (MPD) accounts for 10-40% of cases. We previously described latent MPD in 58.5% of patients with idiopathic BCS, detected with allele-specific PCR for the JAK2V617F mutation and proposed its use as a screening tool for occult MPD. A predisposing germline JAK2 haplotype (designated 46/1) has since been described as a strong genetic risk factor for MPD and may further characterise latent MPD in BCS. We studied 28 patients with BCS (23 from our original cohort; female n=16, mean age 30.3 years, SD 10) presenting between 1985 and 2008; 14 with the JAK2V617F mutation. Genomic DNA was obtained from archived bone marrow films, fractionated and unfractionated peripheral blood or bone marrow leucocytes. Skin biopsy or CD3+ cells were used as a source of constitutional DNA. DNA was analysed by pyrosequencing for 2 SNPs (rs12340895, rs12343867) which tag the 46/1 JAK2 haplotype. The 46/1 haplotype was detected in 16/28 (57.1%) subjects; 50% of those with the JAK2V617F mutation and 64.3% of those without it. The prevalence in those lacking the JAK2V617F mutation is significantly higher than the frequency in the Wellcome Trust Case Control Consortium cohort of 24% (P=0.0023). 3/28 subjects had previously diagnosed JAK2V617F positive Polycythemia Vera (PV) and all had the 46/1 haplotype, resulting in a prevalence of 36.4% in those with JAK2V617F positive latent MPD. Age at presentation of BCS was significantly lower in those with the 46/1 haplotype (26.4 years compared to 34.8 years, P=0.03). This difference remained significant in those lacking the JAK2V617F mutation (24.0 years compared to 37.6 years, P=0.024) but was not seen in those with the JAK2V617F mutation (P=0.547). There was no difference in presenting clinical features, haematological parameters or treatment between those with and without the 46/1 haplotype. Overall survival in 26/28 patients was 76.9% (median 90 months, range 2 days to 266 months). 17/28 subjects underwent OLT of which 14/17 (11/12 with 46/1 haplotype) are alive at a median of 90 months post transplant (range 9-266 months). 3/17 patients developed post-OLT veno-occlusive disease, all with the JAK2V617F mutation and 2/3 with the 46/1 haplotype. Overt MPD has not developed in any patient without the JAK2V617F mutation; repeat JAK2 mutational analysis was undertaken in 3/14 (2/3 with 46/1 haplotype) and none have acquired the mutation at a mean of 54 months. 19/28 cases were genotyped using SNP markers (Affymetrix SNP6); 3/19 have acquired uniparental disomy (aUPD) on 9p overlapping the JAK2 gene. As TET2 has been postulated as a ‘pre-JAK2' aberration, we sequenced the complete TET2 gene using massively parallel high throughput sequencing (Roche 454); 2/15 patients samples were positive for TET2 mutations. One of our cases had a familial history of PV; the patient, his father and uncle all have JAK2V617F positive PV and were heterozygous for the 46/1 haplotype in DNA extracted from a skin biopsy. 2/3 were homozygous for both the 46/1 haplotype and JAK2V617F mutation in bone marrow granulocytes with SNP6 array data confirming aUPD on 9p. JAK2V617F was detected in cultured in vitro colonies from all 3 family members. All 3 affected family members had normal cytogenetics and normal TET2 gene. 3 unaffected siblings were heterozygous for the 46/1 haplotype both in peripheral blood, CD3+ cells and granulocytes but negative for JAK2V617F mutation and lacked aUPD on 9p. We have found a highly significant prevalence of the 46/1 haplotype in our cohort of BCS, as well as in family members of a patient with JAK2V617F positive BCS and PV. The 46/1 haplotype was detected in patients with idiopathic BCS with and without the JAK2V617F mutation, suggesting a predisposition to idiopathic BCS independent of JAK2V617F mutation acquisition and latent MPD. The prevalence and lower age of presentation in those with the 46/1 haplotype lacking the JAK2V617F mutation supports an alternate, as yet unknown, mechanism predisposing to BCS. The presence of the 46/1 haplotype in unaffected relatives of our JAK2V617F BCS patient suggests that additional germline variation may predispose to or protect from acquisition of JAK2V617F positive disease. Alternatively the 46/1 haplotype may directly confer a cellular growth advantage via increased responsiveness of JAK2 to cytokine stimulation. Disclosures: No relevant conflicts of interest to declare.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5208-5208
Author(s):  
Tatiana Tvrdik ◽  
Kristian T. Schafernak ◽  
Jeffrey R Jacobsen ◽  
Reha Toydemir ◽  
Alexandra M Walsh ◽  
...  

Constitutional ring chromosome 21, r(21)c, is a rare chromosome abnormality associated with variable clinical features that range from mild dysmorphism to severe congenital anomalies and intellectual disability. Recently, r(21)c has been reported to predispose to B-cell acute lymphoblastic leukemia (B-ALL) with intrachromosomal amplification of chromosome 21 (iAMP21), a distinct subgroup of high-risk pediatric B-ALL. Only a few iAMP21-B-ALL cases with r(21)c have been reported to date. The mechanism of leukemogenesis of r(21)c has not been entirely elucidated. Here we report an 11-year-old boy with iAMP21-B-ALL carrying an atypical r(21)c. The patient has a history of attention-deficit/hyperactivity disorder, sensorineural hearing loss s/p cochlear implant, intellectual disability and scoliosis. Three months before admission he developed a soft tissue nodule on the occipital scalp deemed to possibly represent an enlarged lymph node. Subsequently, he presented with spontaneous bruising followed by severe epistaxis. The initial CBC showed a white blood cell count of 4.3K/uL with circulating blasts, absolute neutropenia, profound normocytic normochromic anemia (hemoglobin of 5.2 g/dL), and marked thrombocytopenia (platelets, 12K/uL ). Peripheral blood flow cytometry showed 17.9% phenotypically abnormal B lymphoblasts which were negative for CD45, and positive for CD34, nuclear TdT, CD19, CD22, CD79a, CD10, HLA-DR , as well as CD20 (21% positive). The bone marrow aspirate contained 98% blasts. CNS status was 2a (RBC 0, WBC 0, 8% blasts) and clear after the second lumbar puncture. Fine-needle aspiration of the scalp mass demonstrated B-lymphoblastic leukemia/lymphoma. The patient was treated per COG protocol AALL1131 and was assigned to the very high-risk arm when bone marrow interphase FISH showed iAMP21. The chromosome analysis failed to yield metaphase cells on the diagnostic bone marrow sample. A concurrent genomic microarray showed chromothripsis with multiple non-contiguous losses and high copy gains on 21q involving the RUNX1 gene, as well as mosaic deletions within 7q22.3q36.3, 9p24.3p24.1 (including JAK2), 12q12 (several exons of ARID2), 13q14.2q21.2 (RB1, DLEU1/2/7, miR-15a/miR-16-1 cluster), 14q32.33 (IGH locus), 19p13.2 (several exons of the SMARCA4), and mosaic gains within 3q22.3q29 and Xp22.33p11.3. Day 29 end of induction bone marrow examination was positive for minimal residual disease (MRD) at 0.13% of nucleated mononuclear cells, but FISH was negative for iAMP21. On day 57 of consolidation, the bone marrow was negative for both MRD and iAMP21. However, chromosome analysis on both of these follow-up studies showed an abnormal chromosome 21. Chromosome analysis on peripheral blood lymphocytes confirmed the presence of a constitutional r(21). A subsequent genomic microarray analysis on peripheral blood sample did not show chromothripsis observed in the diagnostic bone marrow sample, but showed a 4.7 Mb terminal deletion and two interstitial deletions (3.0 Mb and 5.5 Mb) on the long arm of chromosome 21. These findings are consistent with a r(21) with interstitial deletions, which is likely responsible for the congenital anomalies reported in this patient. iAMP21 is associated with a poor outcome in B-ALL. Accurate detection of iAMP21 is critical for risk stratification and treatment in B-ALL. The strong association between iAMP21 and r(21)c has been proposed based on previous studies on r(21)c carriers with iAMP21-ALL. Our data further support an increased risk of developing iAMP21-ALL in carriers of constitutional r(21) and demonstrate the value of intensive treatment on iAMP21-B-ALL. The r(21) observed in this patient contains a relatively larger (4.7 Mb) terminal deletion along with two additional interstitial deletions. Due to the scarcity of r(21)c, the pathogenetic mechanisms of this leukemic process is not fully understood, and the clinical significance of loss of additional genetic content is unknown. More case reports are needed to generate more comprehensive clinical and genetic profile for this high risk ALL. Figure 1. Genomic microarray findings on diagnostic bone marrow sample (top) and the follow up peripheral blood sample (bottom). Chromothripsis and amplification were observed only in the diagnostic bone marrow specimen, whereas the peripheral blood sample in remission showed two interstitial and a terminal deletion. Figure 1 Disclosures No relevant conflicts of interest to declare.


2011 ◽  
Vol 16 (3) ◽  
pp. 150-154 ◽  
Author(s):  
Leigh Ann Bowe-Geddes

Abstract A group of seven nurses from a range of laboratory and hospital settings across the United States were invited to present opinions and clinical case study examples that reflect the key considerations in peripheral blood sample collection involving lower volume samples and patients affected by difficult venous access (DVA). Panelists were asked to review and compare prevailing standard operating procedures (SOPs) in sample collection and challenges in efforts to expand the use of lower volume sample collection and processing. The discussion identified achievable goals to improve standard of care in lower volume blood sample collection and the treatment of DVA patients.


2008 ◽  
Vol 50 (3) ◽  
pp. 286-300
Author(s):  
Benjamin Wold

Abstract4QInstruction preserves an interpretation of the fifth commandment, to honor one's father and mother, which has similarities with Philo's comments on it. Because Philo's treatment of the command plays a pivotal role in assigning influences on instruction to family members in the New Testament, and the present opinion overwhelmingly views Philo as indebted to Greek schemas and content, evidence from more recently available Qumran literature suggests some of the New Testament Haustafeln may have more of a Jewish intellectual history than is currently acknowledged. This article explores the way biblical traditions—especially the Decalogue and creation traditions—are used for construing teachings to members of the family in the 1 Cor 11, Eph 5-6, Philo and 4QInstruction.


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