{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:37:30Z","timestamp":1785875850550,"version":"3.56.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Myeloproliferative neoplasm (MPN) is a heterogenous group of hematological malignancies including polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). <jats:italic>JAK2<\/jats:italic>V617F is the most frequent driver mutation in all three entities, but in PMF and ET mutations in <jats:italic>CALR<\/jats:italic> and <jats:italic>MPL<\/jats:italic> are also frequent. Mutations seen in additional genes are also often the same regardless of subtype of MPN. The aim of this study was to analyze a population based MPN cohort for genetic variants with prognostic value that can guide clinical decisions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MPN patients from Western Sweden diagnosed between 2008-2013 (n=248) were screened for mutations in 54 genes associated with myeloid malignancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mutations in the genes <jats:italic>SRSF2<\/jats:italic> and <jats:italic>U2AF1<\/jats:italic> correlated significantly with impaired overall survival but did not correlate to increased risk for vascular events, neither before nor after diagnosis. Rather, mutations in these genes showed an association with disease transformation. Several recurrent gene variants with allele frequency close to 50% were confirmed to be germline. However, none of these variants was found to have an earlier onset of MPN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In conclusion, we identified gene mutations to be independent markers of impaired survival in MPN. This indicates the need for more individualized assessment and treatment of MPN patients and a wider gene mutation screening already at diagnosis. This could ensure the identification of patients with high-risk mutations early on. In addition, several genetic variants were also identified as germline in this study but gave no obvious clinical relevance. To avoid conclusions from non-informative genetic variants, a simultaneous analysis of normal cell DNA from patients at diagnosis should be considered.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1190305","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T17:00:08Z","timestamp":1691773208000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The clinical relevance of broad mutational screening of myeloproliferative neoplasms at diagnosis"],"prefix":"10.3389","volume":"13","author":[{"given":"Helna","family":"Pettersson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenni","family":"Adamsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Johansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Staffan","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Palmqvist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Andr\u00e9asson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Asp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.8081.1","article-title":"Recent advances in understanding myelofibrosis and essential thrombocythemia","volume":"5","author":"Vainchenker","year":"2016","journal-title":"F1000Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s13045-021-01116-z","article-title":"Molecular pathogenesis of the myeloproliferative neoplasms","volume":"14","author":"Greenfield","year":"2021","journal-title":"J Hematol Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-03-209262","article-title":"The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes","volume":"114","author":"Vardiman","year":"2009","journal-title":"Blood"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26008","article-title":"Polycythemia vera and essential thrombocythemia: 2021 update on diagnosis, risk-stratification and management","volume":"95","author":"Tefferi","year":"2020","journal-title":"Am J hematology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14081986","article-title":"Next-generation DNA sequencing-based gene panel for diagnosis and genetic risk stratification in onco-hematology","volume":"14","author":"Gargallo","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1111\/bjh.18675","article-title":"Germline predisposition to haematological Malignancies: Best practice consensus guidelines from the UK Cancer Genetics Group (UKCGG), CanGene-CanVar and the NHS England Haematological Oncology Working Group","volume":"201","author":"Speight","year":"2023","journal-title":"Br J Haematol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.8644","article-title":"Germline genetic predisposition to hematologic Malignancy","volume":"35","author":"Furutani","year":"2017","journal-title":"J Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/cells10102597","article-title":"The genetic makeup of myeloproliferative neoplasms: Role of germline variants in defining disease risk, phenotypic diversity and outcome","volume":"10","author":"Masselli","year":"2021","journal-title":"Cells"},{"key":"B9","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.clml.2016.04.001","article-title":"Evaluation of patients and families with concern for predispositions to hematologic Malignancies within the hereditary hematologic Malignancy clinic (HHMC)","volume":"16","author":"DiNardo","year":"2016","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-019-02742-7","article-title":"TERT and JAK2 polymorphisms define genetic predisposition to myeloproliferative neoplasms in Japanese patients","volume":"110","author":"Matsuguma","year":"2019","journal-title":"Int J Hematol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-017-0414-x","article-title":"Familial MPN predisposition","volume":"12","author":"Tashi","year":"2017","journal-title":"Curr hematologic Malignancy Rep"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2015.138958","article-title":"Mutation status of essential thrombocythemia and primary myelofibrosis defines clinical outcome","volume":"101","author":"Asp","year":"2016","journal-title":"Haematologica"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16450","article-title":"ASXL1 mutations, previous vascular complications and age at diagnosis predict survival in 85 WHO-defined polycythaemia vera patients","volume":"189","author":"Andreasson","year":"2020","journal-title":"Br J haematology"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2012.759656","article-title":"Age-related differences in disease characteristics and clinical outcomes in polycythemia vera","volume":"54","author":"Stein","year":"2013","journal-title":"Leuk Lymphoma"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022007201","article-title":"Real-world study of children and young adults with myeloproliferative neoplasms: identifying risks and unmet needs","volume":"6","author":"Sobas","year":"2022","journal-title":"Blood Adv"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-018-0107-z","article-title":"GIPSS: genetically inspired prognostic scoring system for primary myelofibrosis","volume":"32","author":"Tefferi","year":"2018","journal-title":"Leukemia"},{"key":"B17","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1111\/bjh.16380","article-title":"Mutation-enhanced international prognostic systems for essential thrombocythaemia and polycythaemia vera","volume":"189","author":"Tefferi","year":"2020","journal-title":"Br J Haematol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-022-00685-1","article-title":"Molecular pathogenesis of myeloproliferative neoplasms","volume":"17","author":"Rolles","year":"2022","journal-title":"Curr Hematol Malig Rep"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2404854","article-title":"Prospective identification of high-risk polycythemia vera patients based on JAK2(V617F) allele burden","volume":"21","author":"Vannucchi","year":"2007","journal-title":"Leukemia"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412098","article-title":"Effect of mutation order on myeloproliferative neoplasms","volume":"372","author":"Ortmann","year":"2015","journal-title":"N Engl J Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2015.129510","article-title":"DNMT3A mutations occur early or late in patients with myeloproliferative neoplasms and mutation order influences phenotype","volume":"100","author":"Nangalia","year":"2015","journal-title":"Haematologica"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23031013","article-title":"Insights into the potential mechanisms of JAK2V617F somatic mutation contributing distinct phenotypes in myeloproliferative neoplasms","volume":"23","author":"Gou","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B23","doi-asserted-by":"publisher","first-page":"100708","DOI":"10.1016\/j.blre.2020.100708","article-title":"Genomic heterogeneity in myeloproliferative neoplasms and applications to clinical practice","volume":"42","author":"Lee","year":"2020","journal-title":"Blood Rev"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2016.1.552","article-title":"Mutations in MPNs: prognostic implications, window to biology, and impact on treatment decisions","volume":"2016","author":"Shammo","year":"2016","journal-title":"Hematol Am Soc Hematol Educ Program"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-21-2930","article-title":"Myelofibrosis: genetic characteristics and the emerging therapeutic landscape","volume":"82","author":"Tefferi","year":"2022","journal-title":"Cancer Res"},{"key":"B26","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1182\/bloodadvances.2016000216","article-title":"Targeted deep sequencing in polycythemia vera and essential thrombocythemia","volume":"1","author":"Tefferi","year":"2016","journal-title":"Blood Adv"},{"key":"B27","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/bs.ircmb.2021.02.008","article-title":"Mutational landscape of blast phase myeloproliferative neoplasms (MPN-BP) and antecedent MPN","volume":"366","author":"Pasca","year":"2022","journal-title":"Int Rev Cell Mol Biol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022017578","article-title":"Genetic basis and molecular profiling in myeloproliferative neoplasms","volume":"141","author":"Luque Paz","year":"2023","journal-title":"Blood"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1716614","article-title":"Classification and personalized prognosis in myeloproliferative neoplasms","volume":"379","author":"Grinfeld","year":"2018","journal-title":"New Engl J Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-018-0491-5","article-title":"Leukemic transformation of myeloproliferative neoplasms: Therapeutic and genomic considerations","volume":"13","author":"Li","year":"2018","journal-title":"Curr hematologic Malignancy Rep"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-11-537167","article-title":"Clonal evolution and clinical correlates of somatic mutations in myeloproliferative neoplasms","volume":"123","author":"Lundberg","year":"2014","journal-title":"Blood"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.00321","article-title":"The role of new technologies in myeloproliferative neoplasms","volume":"9","author":"Palumbo","year":"2019","journal-title":"Front Oncol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2013.119","article-title":"Mutations and prognosis in primary myelofibrosis","volume":"27","author":"Vannucchi","year":"2013","journal-title":"Leukemia"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408617","article-title":"Age-related clonal hematopoiesis associated with adverse outcomes","volume":"371","author":"Jaiswal","year":"2014","journal-title":"N Engl J Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13579","article-title":"Combination of myeloproliferative neoplasm driver gene activation with mutations of splice factor or epigenetic modifier genes increases risk of rapid blastic progression","volume":"106","author":"Bartels","year":"2021","journal-title":"Eur J Haematol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-019-0668-5","article-title":"Mutations associated with age-related clonal hematopoiesis in PMF patients with rapid progression to myelofibrosis","volume":"34","author":"Bartels","year":"2020","journal-title":"Leukemia"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-03-143602","article-title":"Increased risks of polycythemia vera, essential thrombocythemia, and myelofibrosis among 24,577 first-degree relatives of 11,039 patients with myeloproliferative neoplasms in Sweden","volume":"112","author":"Landgren","year":"2008","journal-title":"Blood"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1038\/s41568-020-00315-z","article-title":"Advances in germline predisposition to acute leukaemias and myeloid neoplasms","volume":"21","author":"Klco","year":"2021","journal-title":"Nat Rev Cancer"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021011354","article-title":"Identification and prioritization of myeloid Malignancy germline variants in a large cohort of adult patients with AML","volume":"139","author":"Yang","year":"2022","journal-title":"Blood"},{"key":"B40","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1007\/s11899-022-00663-7","article-title":"Germline CHEK2 and ATM variants in myeloid and other hematopoietic Malignancies","volume":"17","author":"Stubbins","year":"2022","journal-title":"Curr hematologic Malignancy Rep"},{"key":"B41","doi-asserted-by":"publisher","first-page":"7553","DOI":"10.1038\/ncomms8553","article-title":"Inherited coding variants at the CDKN2A locus influence susceptibility to acute lymphoblastic leukaemia in children","volume":"6","author":"Xu","year":"2015","journal-title":"Nat Commun"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1190305\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T17:00:13Z","timestamp":1691773213000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1190305\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,11]]},"references-count":41,"alternative-id":["10.3389\/fonc.2023.1190305"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2023.1190305","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,11]]},"article-number":"1190305"}}