HAEM5:Essential thrombocythaemia: Difference between revisions

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Rebecca Smith, PhD, Director, Genetics Associates, Nashville, TN

==WHO Classification of Disease==

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Very rarely, cases of ET acquire a BCR-ABL1 rearrangement. Consequently, in this situation, a morphological and hematological shift capable of chronic myeloid leukemia evolution may occur<ref>{{Cite journal|last=K|first=Hussein|last2=O|first2=Bock|last3=K|first3=Theophile|last4=A|first4=Seegers|last5=H|first5=Arps|last6=O|first6=Basten|last7=Kh|first7=Grips|last8=J|first8=Franz-Werner|last9=G|first9=Büsche|date=2008|title=Chronic myeloproliferative diseases with concurrent BCR-ABL junction and JAK2V617F mutation|url=https://pubmed.ncbi.nlm.nih.gov/17972958/|language=en|pmid=17972958}}</ref>

* Chromosomal Rearrangements (Gene Fusions)

* Individual Region Genomic Gain/Loss/LOH

* Gene Mutations (SNV/INDEL)}}</blockquote>

Treatment for ET is usually kept to a minimum and the patient is monitored for progression to leukemia and post-ET myelofibrosis. The main indication for treatment of ET is to prevent thrombosis. There are four major risk categories for thrombosis risk<ref>{{Cite journal|last=Tefferi|first=Ayalew|last2=Vannucchi|first2=Alessandro M.|last3=Barbui|first3=Tiziano|date=2018|title=Essential thrombocythemia treatment algorithm 2018|url=http://www.nature.com/articles/s41408-017-0041-8|journal=Blood Cancer Journal|language=en|volume=8|issue=1|doi=10.1038/s41408-017-0041-8|issn=2044-5385|pmc=PMC5802626|pmid=29321520}}</ref>:  

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Uniparental disomy (UPD) in Essential Thrombocythemia has not been reported. Conversely, UPD of chromosome 9p (typically causing homozygosity of JAK2 pathogenic variants) is a frequent clonal occurrence in polycythemia vera (PV) <ref>{{Cite journal|last=Kralovics|first=R|date=2002|title=Acquired uniparental disomy of chromosome 9p is a frequent stem cell defect in polycythemia vera|url=https://linkinghub.elsevier.com/retrieve/pii/S0301472X01007895|journal=Experimental Hematology|volume=30|issue=3|pages=229–236|doi=10.1016/S0301-472X(01)00789-5}}</ref>.

!Chromosomal Pattern

!Molecular Pathogenesis

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An abnormal karyotype is found in 5-10% of cases; however, there is no consistent abnormality. Reported, but non-specific, abnormalities in ET include gain of chromosome 8, abnormalities of 9q, and del(20q). Isolated instances of del(5q) have also been reported in ET<ref name=":0" />.

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|}Note: A more extensive list of mutations can be found in [https://www.cbioportal.org/ <u>cBioportal</u>], [https://cancer.sanger.ac.uk/cosmic <u>COSMIC</u>], and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content.

Most cases of ET harbor a phenotypic driver mutation in JAK2 (50-60% of ET cases), CALR (in 30%), or MPL (in 3%), and about 13% of ET are triple negative for these mutations. None of these mutations are specific for ET; however, the presence of these mutations would rule out reactive or secondary thrombocytosis<ref name=":0" />.  

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'''JAK2'''

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==Notes==

          

<nowiki>*</nowiki>''Citation of this Page'': “Essential thrombocythaemia”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated {{REVISIONMONTH}}/{{REVISIONDAY}}/{{REVISIONYEAR}}, <nowiki>https://ccga.io/index.php/HAEM5:Essential_thrombocythaemia</nowiki>.