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What Contributes to the Appearance of Dual MPNs?

Am J Hematol; 2017 Jun; Kandarpa, Wu, et al

Hematopoietic cells from patients with myeloproliferative neoplasms (MPNs) harbor multiple genetic aberrations that can contribute to clonal dominance, according to a recent study.

Investigators looked at neoplastic cells from patients with dual MPNs using next-generation sequencing to see if they could characterize the underlying genetic events that might contribute to the appearance of more than one MPN. Among the results:

  • Most patients with two MPNs harbored mutations in genes known to contribute to clonal hematopoiesis through altered epigenetic regulation such as TET2, ASXL1/2, SRSF2, and IDH2 at varying frequencies.
  • Some patients also harbored oncogenic mutations in N/KRAS, TP53, BRAF, EZH2, and GNAS at low frequencies, reflective of clonal evolution.


Kandarpa M, Wu Y, Robinson D, Burke P, Chinnaiyan A, Talpaz M. Clinical characteristics and whole exome/transcriptome sequencing of coexisting chronic myeloid leukemia and myelofibrosis. Am J Hematol. 2017;92(6):555-561. doi:10.1002/ajh.24728.