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Treatment with azacitidine (AZA), a demethylating agent, prolonged overall survival (OS) vs conventional care in patients with higher-risk myelodysplastic syndromes (MDS). As median survival with monotherapy is

Randomized phase 3 study of lenalidomide versus chlorambucil as first-line therapy for older patients with chronic lymphocytic leukemia (the ORIGIN trial)

Analysis of lineage involvement was performed in 17 Philadelphia chromosome-positive acute lymphoblastic leukemia patients with no history of chronic myeloproliferative disorder. The percentage of blastic cells as defined by flow cytometry matched that of the Ph-positive cells in 14 out of 17 patients. The bcr-abl rearrangement was investigated by fluorescent in situ hybridization in morphologically identified blastic cells, myeloid elements, lymphocytes and erythroblasts using a combined light and fluorescent microscopical imaging. Lymphoid lineage restriction could be determined in all but three of the patients. These 14 patients exhibited heterogeneity in terms of m-bcr and M-bcr types of translocation as revealed by reverse transcription polymerase chain reaction. The three patients with multilineage involvement and M-bcr type of translocation reverted to chronic phase and the percentage of Ph-positive cells remained high. Thus, we could identify an uncommitted stem cell origin among Ph-positive ALLs only in those patients whose disease subsequently proved to be a lymphoid blastic crisis with clinically silent chronic phase.

Somatic gain-of-function mutation of the Janus kinase (JAK2) gene (NM_004972.2: c.1849G>T transversion resulting in V617F) has been identified in BCR–ABL-negative chronic myeloproliferative neoplasms (MPNs) (in >95% of polycythaemia vera (PV), and in 40–60% of essential thrombocythaemia (ET) and primary myelofibrosis (PMF)). The inherited genetic background of an individual patient has been long predicted to influence disease susceptibility and phenotype in MPN. Recent studies have demonstrated that the presence of JAK2 V617F is associated with an inherited JAK2 haplotype designated as ‘46/1’ haplotype.1, 2, 3 Carriers of the 46/1 haplotype have higher risk of acquiring JAK2 V617F mutation, but the role of 46/1 haplotype as a predisposition factor for V617F-negative MPN is still remained controversial. Only a few studies4, 5 investigated the potential role of the 46/1 haplotype as a MPN phenotype modifier in the context of the frequency of complications affecting life expectancy, such as thrombosis and myelofibrotic or leukaemic transformation. To extend these observations, the aims of our study were the following: (a) to examine and confirm associations of MPN and the presence of the JAK2 46/1 haplotype in Hungarian V617F-positive and -negative MPN patients; (b) to examine associations of the 46/1 haplotype with distinct clinical characteristics of MPN, (c) to test the haplotype frequency among JAK2 V617F-negative acute myeloid leukemia (AML) patients.