Competing cell clones in myeloproliferative neoplasm.

摘要

Patients with classic myeloproliferative neoplasms (MPNs) share a risk of transformation from a chronic phase (CP) to blast phase (BP; ie, acute myeloid leukemia, AML). Interestingly, JAK2V617F mutation detectable in most patients in CP can become undetectable upon transformation to BP, strongly suggesting that the event leading to transformation happens in JAK2V617F-negative cell clone. Recently, other mutations (eg, TET2, ASXL1, IDH1/2, RUNX1, and RAS) have been found in MPN, some possibly with higher incidence in BP than in CP, suggesting their role in the transformative process.Here we report a case that supports these recent observations of competing cell clones in MPN.