Introduction: The identification of mutations of the JAK2 gene is a useful marker in the diagnosis of polycythemia vera (PV) patients. We studied the frequency of JAK2 mutations in a group of PV patients because data are still very limited regarding this subject in Polish patients. Methods: The JAK2 V617F mutation was examined using the amplification refractory mutation system (ARMS)-PCR method. Direct sequencing and a cloning technique were performed to determine alternations in exon 12 of the JAK2 gene. Results: A group of 90 consecutive patients with a suspected diagnosis of polycythemia vera were investigated. In 91% of the cases, the JAK2 V617F mutation was identified. The remaining JAK2 V617F-negative patients were subjected to examination for JAK2 exon 12 by direct PCR product sequencing and the cloning technique. The following mutations were identified: H538-K539delinsL, E543-D544del and N542-E543del. These exon 12 mutants constituted 50% of PV JAK2 V617F-negative group and 4.4% (out of 90) of all PV patients (JAK2 V617F-positive and JAK2 V617F-negative). Conclusion: Our results demonstrate the prevalence of JAK2 mutations (V617F and in exon 12) in PV cases. Moreover, the data show that direct sequencing is not an adequate technique for exon 12 mutation identification; therefore, appropriate methodology should be considered for using this molecular marker in the process of diagnosis.

1.
James C, Ugo V, Le Couédic JP, Staerk J, Delhommeau F, Lacout C, Garçon L, Raslova H, Berger R, Bennaceur-Griscelli A, Villeval JL, Constantinescu SN, Casadevall N, Vainchenker W: A unique clonal JAK2 mutation leading to constitutive signaling causes polycythaemia vera. Nature 2005;434:1144-1148.
2.
Kralovics R, Passamonti F, Buser AS, Teo SS, Tiedt R, Passweg JR, Tichelli A, Cazzola M, Skoda RC: A gain-of-function mutation of JAK2 in myeloproliferative disorders. N Engl J Med 2005;352:1779-1790.
3.
Baxter EJ, Scott LM, Campbell PJ, East C, Fourouclas N, Swanton S, Vassiliou GS, Bench AJ, Boyd EM, Curtin N, Scott MA, Erber WN, Green AR; Cancer Genome Project: Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders. Lancet 2005;365:1054-1061.
4.
Scott LM, Tong W, Levine RL, Scott MA, Beer PA, Stratton MR, Futreal PA, Erber WN, McMullin MF, Harrison CN, Warren AJ, Gilliland DG, Lodish HF, Green AR: JAK2 exon 12 mutations in polycythemia vera and idiopathic erythrocytosis. N Engl J Med 2007;356:459-468.
5.
Williams DM, Kim AH, Rogers O, Spivak JL, Moliterno AR: Phenotypic variations and new mutations in JAK2 V617F-negative polycythemia vera, erythrocytosis, and idiopathic myelofibrosis. Exp Hematol 2007;35:1641-1646.
6.
Ma W, Kantarjian H, Zhang X, Yeh CH, Zhang ZJ, Verstovsek S, Albitar M: Mutation profile of JAK2 transcripts in patients with chronic myeloproliferative neoplasias. J Mol Diagn 2009;11:49-53.
7.
Jones AV, Kreil S, Zoi K, Waghorn K, Curtis C, Zhang L, Score J, Seear R, Chase AJ, Grand FH, White H, Zoi C, Loukopoulos D, Terpos E, Vervessou EC, Schultheis B, Emig M, Ernst T, Lengfelder E, Hehlmann R, Hochhaus A, Oscier D, Silver RT, Reiter A, Cross NC: Widespread occurrence of the JAK2 V617F mutation in chronic myeloproliferative disorders. Blood 2005;106:2162-2168.
8.
Wang YL, Vandris K, Jones A, Cross NC, Christos P, Adriano F, Silver RT: JAK2 mutations are present in all cases of polycythemia vera. Leukemia 2008;22:1289.
9.
Scott LM: The JAK2 exon 12 mutations: a comprehensive review. Am J Hematol 2011;86:668-676.
10.
Zhang SP, Li H, Lai RS: Detection of JAK2 V617F mutation increases the diagnosis of myeloproliferative neoplasms. Oncol Lett 2015;9:735-738.
11.
Lin Y, Liu E, Sun Q, Ma J, Li Q, Cao Z, Wang J, Jia Y, Zhang H, Song Z, Ai X, Shi L, Feng X, Li C, Wang J, Ru K: The prevalence of JAK2, MPL, and CALR mutations in Chinese patients with BCR-ABL1-negative myeloproliferative neoplasms. Am J Clin Pathol 2015;144:165-171.
12.
Siemiatkowska A, Bieniaszewska M, Hellmann A, Limon J: JAK2 and MPL gene mutations in V617F-negative myeloproliferative neoplasms: Leuk Res 2010;34:387-389.
13.
Bernardi M, Ruggeri M, Albiero E, Madeo D, Rodeghiero F: Isolated erythrocytosis in V617F negative patients with JAK2 exon 12 mutations: report of a new mutation. Am J Hematol 2009;84:258-260.
14.
Yeh YM, Chen YL, Cheng HY, Su WC, Chow NH, Chen TY, Ho CL: High percentage of JAK2 exon 12 mutation in Asian patients with polycythemia vera. Am J Clin Pathol 2010;134:266-270.
15.
Furtado LV, Weigelin HC, Elenitoba-Johnson KS, Betz BL: A multiplexed fragment analysis-based assay for detection of JAK2 exon 12 mutations. J Mol Diagn 2013;15:592-599.
16.
Butcher CM, Hahn U, To LB, Gecz J, Wilkins EJ, Scott HS, Bardy PG, D'Andrea RJ: Two novel JAK2 exon 12 mutations in JAK2V617F-negative polycythaemia vera patients. Leukemia 2008;22:870-873.
17.
Ohyashiki JH, Hisatomi H, Shimizu S, Sugaya M, Ohyashiki K: Detection of low allele burden of JAK2 exon 12 mutations using TA-cloning in patients with erythrocytosis. Jpn J Clin Oncol 2009;39:509-513.
18.
Kambas K, Mitroulis I, Kourtzelis I, Chrysanthopoulou A, Speletas M, Ritis K: Fast and reliable mutation detection of the complete exon 11-15 JAK2 coding region using non-isotopic RNase cleavage assay (NIRCA). Eur J Haematol 2009;83:215-219.
19.
Shivarov V, Ivanova M, Yaneva S, Petkova N, Hadjiev E, Naumova E: Quantitative bead-based assay for detection of JAK2 exon 12 mutations. Leuk Lymphoma 2013;54:1343-1344.
20.
Alghasham N, Alnouri Y, Abalkhail H, Khalil S: Detection of mutations in JAK2 exons 12-15 by Sanger sequencing. Int J Lab Hematol 2016;38:34-41.
21.
Labastida-Mercado N, Galindo-Becerra S, Garcés-Eisele J, Colunga-Pedraza P, Guzman-Olvera V, Reyes-Nuñez V, Ruiz-Delgado GJ, Ruiz-Argüelles GJ: The mutation profile of JAK2, MPL and CALR in Mexican patients with Philadelphia chromosome-negative myeloproliferative neoplasms. Hematol Oncol Stem Cell Ther 2015;8:16-21.
22.
Ugo V, Tondeur S, Menot ML, Bonnin N, Le Gac G, Tonetti C, Mansat-De Mas V, Lecucq L, Kiladjian JJ, Chomienne C, Dosquet C, Parquet N, Darnige L, Porneuf M, Escoffre-Barbe M, Giraudier S, Delabesse E, Cassinat B; French Intergroup of Myeloproliferative Disorders: Interlaboratory development and validation of a HRM method applied to the detection of JAK2 exon 12 mutations in polycythemia vera patients. PLoS One 2010;5:e8893.
23.
Jones AV, Cross NC, White HE, Green AR, Scott LM: Rapid identification of JAK2 exon 12 mutations using high resolution melting analysis. Haematologica 2008;93:1560-1564.
24.
Kjær L, Westman M, Hasselbalch Riley C, Høgdall E, Weis Bjerrum O, Hasselbalch H: A highly sensitive quantitative real-time PCR assay for determination of mutant JAK2 exon 12 allele burden. PLoS One 2012;7:e33100.
25.
Theocharides A, Passweg JR, Medinger M, Looser R, Li S, Hao-Shen H, Buser AS, Gratwohl A, Tichelli A, Skoda RC: The allele burden of JAK2 mutations remains stable over several years in patients with myeloproliferative disorders. Haematologica 2008;93:1890-1893.
26.
Grünebach F, Bross-Bach U, Kanz L, Brossart P: Detection of a new JAK2 D620E mutation in addition to V617F in a patient with polycythemia vera. Leukemia 2006;20:2210-2211.
27.
Karow A, Waller C, Reimann C, Niemeyer CM, Kratz CP: JAK2 mutations other than V617F: a novel mutation and mini review. Leuk Res 2008;32:365-366.
28.
Yoo JH, Park TS, Maeng HY, Sun YK, Kim YA, Kie JH, Cho EH, Song J, Lee KA, Suh B, Choi JR: JAK2 V617F/C618R mutation in a patient with polycythemia vera: a case study and review of the literature. Cancer Genet Cytogenet 2009;189:43-47.
29.
Bench AJ, White HE, Foroni L, Godfrey AL, Gerrard G, Akiki S, Awan A, Carter I, Goday-Fernandez A, Langabeer SE, Clench T, Clark J, Evans PA, Grimwade D, Schuh A, McMullin MF, Green AR, Harrison CN, Cross NC; British Committee for Standards in Haematology: Molecular diagnosis of the myeloproliferative neoplasms: UK guidelines for the detection of JAK2 V617F and other relevant mutations. Br J Haematol 2013;160:25-34.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.