International Journal of Hematology and Oncology
2024, Vol 34, Num 1 Page(s): 083-091
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The Impact of JAK2 Mutation on Thrombosis in Philadelphia Chromosome-Negative Chronic Myeloproliferative Neoplasms
Ayse ARSLAN KAPUCI1, Pinar TIGLIOGLU2, Lutfiye Tuba HANCI3, Hanife SAAT4, Umit Yavuz MALKAN5
1Ankara Etlik State Hospital, Department of Internal Medicine, Ankara, Turkey
2Dr. Ersin Arslan Training and Research Hospital, Department of Hematology, Ankara, Turkey
3Bakircay University, Cigli Training and Research Hospital, Department of Biochemistry, Ankara, Turkey
4Ankara Etlik State Hospital, Department of Genetic, Ankara, Turkey
5Hacettepe University, Faculty of Medicine, Department of Hematology, Ankara, Turkey
Keywords: Polycytemia vera, Essential thrombosis, Primary myelofibrosis, JAK mutation, Thrombosis
Chronic myeloproliferative neoplasms (CMNs) are related to clonal over-proliferation of hematopoietic stem cells. Polycythemia vera,essential thrombocythemia and primary myelofibrosis are included in CMNs.An important complication of these diseases is thrombotic events. The relationship between Janus Kinase gene mutation and thrombosis in CMNs is still debated. Herein, we have aimed to investigate the impact of JAK2 mutation on thrombosis in philadelphia negative (Ph-) CMNs. The present study included 208 patients with Ph-CMNs who applied to the hematology clinic of Diskapi Yildirim Beyazit Training and Research Hospital for treatment and followed-up between 2013-2019. The patient data were retrospectively reviewed.Statistical analysis was performed with
SPSS V.25.0. The statistical significance level was accepted as p< 0.05.Multivariate analysis was performed to the variables with p< 0.01 in the univariate analysis. When comparing the thrombosis and non-thrombosis groups in univariate logistic regression analysis, there was a borderline statistically significant difference in gender (p= 0.058) and statistically significant differences were found in the
presence of diabetes mellitus (p= 0.001), hypertension (p< 0.001), hyperlipidemia (p= 0.025) and serum calcium (p= 0.028).According to multivariate logistic regression analysis,gender (p= 0.032), diabetes mellitus (p= 0.027),and serum calcium (p= 0.031) were found to be associated with thrombosis. When these three parameters were examined together, 94.2% sensitivity and 43.8% specificity
were detected. The overall predictive accuracy for thrombosis was found to be 84.2%.Also there was statistically significant difference in sedimentation, C-reactive protein, AST levels and size of liver between the thrombotic and non-thrombotic patients in univariate analysis. There was no statistically significant relationship between the presence of JAK2 mutation (p= 0.637) and JAK2 allele burden
(p= 0.885) with thrombosis. Cardiovascular risk factors were found to be related with thrombosis in Ph-CMNs rather than presence of JAK2 mutation or JAK2 allele burden.
Ayse ARSLAN KAPUCI1, Pinar TIGLIOGLU2, Lutfiye Tuba HANCI3, Hanife SAAT4, Umit Yavuz MALKAN5
1Ankara Etlik State Hospital, Department of Internal Medicine, Ankara, Turkey
2Dr. Ersin Arslan Training and Research Hospital, Department of Hematology, Ankara, Turkey
3Bakircay University, Cigli Training and Research Hospital, Department of Biochemistry, Ankara, Turkey
4Ankara Etlik State Hospital, Department of Genetic, Ankara, Turkey
5Hacettepe University, Faculty of Medicine, Department of Hematology, Ankara, Turkey
Keywords: Polycytemia vera, Essential thrombosis, Primary myelofibrosis, JAK mutation, Thrombosis
Chronic myeloproliferative neoplasms (CMNs) are related to clonal over-proliferation of hematopoietic stem cells. Polycythemia vera,essential thrombocythemia and primary myelofibrosis are included in CMNs.An important complication of these diseases is thrombotic events. The relationship between Janus Kinase gene mutation and thrombosis in CMNs is still debated. Herein, we have aimed to investigate the impact of JAK2 mutation on thrombosis in philadelphia negative (Ph-) CMNs. The present study included 208 patients with Ph-CMNs who applied to the hematology clinic of Diskapi Yildirim Beyazit Training and Research Hospital for treatment and followed-up between 2013-2019. The patient data were retrospectively reviewed.Statistical analysis was performed with
SPSS V.25.0. The statistical significance level was accepted as p< 0.05.Multivariate analysis was performed to the variables with p< 0.01 in the univariate analysis. When comparing the thrombosis and non-thrombosis groups in univariate logistic regression analysis, there was a borderline statistically significant difference in gender (p= 0.058) and statistically significant differences were found in the
presence of diabetes mellitus (p= 0.001), hypertension (p< 0.001), hyperlipidemia (p= 0.025) and serum calcium (p= 0.028).According to multivariate logistic regression analysis,gender (p= 0.032), diabetes mellitus (p= 0.027),and serum calcium (p= 0.031) were found to be associated with thrombosis. When these three parameters were examined together, 94.2% sensitivity and 43.8% specificity
were detected. The overall predictive accuracy for thrombosis was found to be 84.2%.Also there was statistically significant difference in sedimentation, C-reactive protein, AST levels and size of liver between the thrombotic and non-thrombotic patients in univariate analysis. There was no statistically significant relationship between the presence of JAK2 mutation (p= 0.637) and JAK2 allele burden
(p= 0.885) with thrombosis. Cardiovascular risk factors were found to be related with thrombosis in Ph-CMNs rather than presence of JAK2 mutation or JAK2 allele burden.
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