Predictors of clinical outcome in myeloproliferative neoplasm, unclassifiable: A Bone Marrow Pathology Group study.

Autor:	Crane GM; Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, US., Geyer JT; Department of Pathology, Weill Cornell Medicine, New York, NY, US., Thakral B; Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US., Wang SA; Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US., Wool GD; Department of Pathology, University of Chicago, Chicago, IL, US., Li KD; Department of Pathology, University of Utah, Salt Lake City, UT, US., Davis AR; Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, US., Boiocchi L; Department of Pathology, Massachusetts General Hospital, Boston, MA, US., Bosler D; Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, US., Bueso-Ramos CE; Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US., Arber DA; Department of Pathology, University of Chicago, Chicago, IL, US., George TI; Department of Pathology, University of Utah, Salt Lake City, UT, US., Bagg A; Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, US., Hasserjian RP; Department of Pathology, Massachusetts General Hospital, Boston, MA, US., Orazi A; Department of Pathology, Texas Tech University Health Science Center, El Paso, TX, US., Hsi ED; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, US., Rogers HJ; Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, US.
Jazyk:	angličtina
Zdroj:	American journal of clinical pathology [Am J Clin Pathol] 2024 Sep 03; Vol. 162 (3), pp. 233-242.
DOI:	10.1093/ajcp/aqae033
Abstrakt:	Objectives: Myeloproliferative neoplasm, unclassifiable (MPN-U, revised to MPN, not otherwise specified in the fifth edition of the World Health Organization classification) is a heterogeneous category of primary marrow disorders with clinical, morphologic, and/or molecular features that preclude classification as a more specific MPN subtype due to stage at diagnosis, overlapping features between MPN subtypes, or the presence of coexisting disorders. Compared with other MPN subtypes, the contribution of the mutational landscape in MPN-U in conjunction with other clinical and morphologic biomarkers to prognosis has been less well investigated. Methods: We performed a multicenter, retrospective study of MPN-U (94 cases) to better define the clinicopathologic features, genetic landscape, and clinical outcomes, including subgroups of early-stage, advanced-stage, and coexisting disorders. The Dynamic International Prognostic Scoring System (DIPSS) plus scoring system was applied to assess its relevance to MPN-U prognosis. Results: Multivariate analysis demonstrated bone marrow blast count and DIPSS plus score as statistically significant in predicting overall survival. Univariate analysis identified additional potential poor prognostic markers, including abnormal karyotype and absence of JAK2 mutation. Secondary mutations were frequent in the subset analyzed by next-generation sequencing (26/37 cases, 70.3%) with a borderline association between high molecular risk mutations and overall survival. Conclusions: This study, as one of the largest of MPN-U studies incorporating both clinicopathologic and molecular data, moves toward identification of biomarkers that better predict prognosis in this heterogeneous category. (© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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