{"id":{"repo_id":"soton","oai_identifier":"oai:eprints.soton.ac.uk:162665"},"canonical_url":"https://search.dev.ndltd.org/etd/soton/oai:eprints.soton.ac.uk:162665","repository":{"repo_id":"soton","name":"University of Southampton","base_url":"https://eprints.soton.ac.uk/cgi/oai2"},"display":{"title":"The molecular pathogenesis of myeloproliferative neoplasms","abstract":"Myeloproliferative neoplasms (MPNs) are a heterogeneous group of haematological stem cell<br/>malignancies characterised by proliferation of one or more cells of the myeloid lineage. The molecular<br/>investigation of MPN was revolutionized in 2005 by the finding that approximately 95% of cases with<br/>polycythaemia vera (PV) and 50-60% of cases of essential thrombocythaemia (ET) and primary<br/>myelofibrosis (PMF) are characterised by a single acquired mutation, JAK2 V617F. My study has<br/>focused on four principal areas:<br/><br/>(i) Involvement of V617F in other myeloid disorders. After developing sensitive methods to<br/>detect and quantify V617F, this mutation was identified in 17% of cases of atypical chronic myeloid<br/>leukaemia (17/99) as well as other atypical MPN, thus demonstrating that it was more widely<br/>involved in myeloid disorders that initially thought. Homozygosity of V617F was shown to have arisen<br/>by acquired uniparental disomy (UPD) and examination of two cases with V617F plus either KIT<br/>D816V or BCR-ABL demonstrated that the mutations had arisen in independent clones.<br/><br/>(ii) In vitro assays to predict imatinib sensitivity. Haemopoietic colony and liquid cultures were<br/>used to determine if peripheral blood or bone marrow cells from atypical MPN cases (n=200) were<br/>sensitive to imatinib. Of those that responded in one or both cultures (n=185) some had known<br/>abnormalities of PDGFRA or PDGFRB, but a significant minority proved negative for all molecular tests<br/>suggesting the presence of uncharacterised imatinib-sensitive mutations.<br/><br/>(iii) V617F as a marker of response to therapy. JAK2 V617F was used as a molecular marker to<br/>monitor the response of PV patients (n=21) to therapy with imatinib and interferon-?. Neither<br/>therapy eradicated V617F but there was a modest reduction in %V617F which correlated with<br/>haematological response. By contrast, in those patients that did not respond (n=13) the %V617F<br/>marginally increased.<br/><br/>(iv) Genetic predisposition to MPN. Whilst investigating the possible contribution of JAK2 single<br/>nucleotide polymorphisms to the phenotypic diversity associated with V617F, marked skewing of<br/>alleles associated with the mutation was observed. Further investigation revealed that V617Fassociated<br/>disease is strongly associated with a specific constitutional JAK2 haplotype, designated<br/>46/1, in all three disease entities compared to healthy controls (PV, n=192, P=2.9x10-16; ET, n=78,<br/>P=8.2x10-9 and MF, n=41, P=8.0x10-5). Furthermore, allele-specific PCR demonstrated that V617F<br/>specifically arises on the 46/1 allele in most cases. The 46/1 JAK2 haplotype thus predisposes to the<br/>development of V617F associated MPNs (OR=3.7; 95% CI 3.1-4.3) and provides a model whereby a<br/>constitutional genetic factor is associated with an increased risk of acquiring a specific somatic<br/>mutation.","abstract_html":"Myeloproliferative neoplasms (MPNs) are a heterogeneous group of haematological stem cell&lt;br/&gt;malignancies characterised by proliferation of one or more cells of the myeloid lineage. The molecular&lt;br/&gt;investigation of MPN was revolutionized in 2005 by the finding that approximately 95% of cases with&lt;br/&gt;polycythaemia vera (PV) and 50-60% of cases of essential thrombocythaemia (ET) and primary&lt;br/&gt;myelofibrosis (PMF) are characterised by a single acquired mutation, JAK2 V617F. My study has&lt;br/&gt;focused on four principal areas:&lt;br/&gt;&lt;br/&gt;(i) Involvement of V617F in other myeloid disorders. After developing sensitive methods to&lt;br/&gt;detect and quantify V617F, this mutation was identified in 17% of cases of atypical chronic myeloid&lt;br/&gt;leukaemia (17/99) as well as other atypical MPN, thus demonstrating that it was more widely&lt;br/&gt;involved in myeloid disorders that initially thought. Homozygosity of V617F was shown to have arisen&lt;br/&gt;by acquired uniparental disomy (UPD) and examination of two cases with V617F plus either KIT&lt;br/&gt;D816V or BCR-ABL demonstrated that the mutations had arisen in independent clones.&lt;br/&gt;&lt;br/&gt;(ii) In vitro assays to predict imatinib sensitivity. Haemopoietic colony and liquid cultures were&lt;br/&gt;used to determine if peripheral blood or bone marrow cells from atypical MPN cases (n=200) were&lt;br/&gt;sensitive to imatinib. Of those that responded in one or both cultures (n=185) some had known&lt;br/&gt;abnormalities of PDGFRA or PDGFRB, but a significant minority proved negative for all molecular tests&lt;br/&gt;suggesting the presence of uncharacterised imatinib-sensitive mutations.&lt;br/&gt;&lt;br/&gt;(iii) V617F as a marker of response to therapy. JAK2 V617F was used as a molecular marker to&lt;br/&gt;monitor the response of PV patients (n=21) to therapy with imatinib and interferon-?. Neither&lt;br/&gt;therapy eradicated V617F but there was a modest reduction in %V617F which correlated with&lt;br/&gt;haematological response. By contrast, in those patients that did not respond (n=13) the %V617F&lt;br/&gt;marginally increased.&lt;br/&gt;&lt;br/&gt;(iv) Genetic predisposition to MPN. Whilst investigating the possible contribution of JAK2 single&lt;br/&gt;nucleotide polymorphisms to the phenotypic diversity associated with V617F, marked skewing of&lt;br/&gt;alleles associated with the mutation was observed. Further investigation revealed that V617Fassociated&lt;br/&gt;disease is strongly associated with a specific constitutional JAK2 haplotype, designated&lt;br/&gt;46/1, in all three disease entities compared to healthy controls (PV, n=192, P=2.9x10-16; ET, n=78,&lt;br/&gt;P=8.2x10-9 and MF, n=41, P=8.0x10-5). Furthermore, allele-specific PCR demonstrated that V617F&lt;br/&gt;specifically arises on the 46/1 allele in most cases. The 46/1 JAK2 haplotype thus predisposes to the&lt;br/&gt;development of V617F associated MPNs (OR=3.7; 95% CI 3.1-4.3) and provides a model whereby a&lt;br/&gt;constitutional genetic factor is associated with an increased risk of acquiring a specific somatic&lt;br/&gt;mutation.","abstract_has_math":false,"creators":["Jones, Amy Victoria"],"institution":"University of Southampton","degree_name":"Ph.D.","degree_level":"doctoral","degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Cross, Nicholas"],"committee_chairs":[],"committee_members":[],"year":2010,"date_issued":"2010-06","date_published":"2010-06","updated_at":"2026-07-24T04:36:17Z","subjects":[],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":null,"outbound_label":null,"outbound_source":null},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Cross, Nicholas"]},{"key":"dc:creator","label":"Author","values":["Jones, Amy Victoria"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2010-06"]},{"key":"dc:date.issued","label":"Date","values":["2010-06"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Human Genetics (pre 2011 reorg)","School of Medicine"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Southampton"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["https://eprints.soton.ac.uk/162665/"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["doctoral"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["Ph.D."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://eprints.soton.ac.uk/162665/1/Amy_final_version.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Myeloproliferative neoplasms (MPNs) are a heterogeneous group of haematological stem cell<br/>malignancies characterised by proliferation of one or more cells of the myeloid lineage. The molecular<br/>investigation of MPN was revolutionized in 2005 by the finding that approximately 95% of cases with<br/>polycythaemia vera (PV) and 50-60% of cases of essential thrombocythaemia (ET) and primary<br/>myelofibrosis (PMF) are characterised by a single acquired mutation, JAK2 V617F. My study has<br/>focused on four principal areas:<br/><br/>(i) Involvement of V617F in other myeloid disorders. After developing sensitive methods to<br/>detect and quantify V617F, this mutation was identified in 17% of cases of atypical chronic myeloid<br/>leukaemia (17/99) as well as other atypical MPN, thus demonstrating that it was more widely<br/>involved in myeloid disorders that initially thought. Homozygosity of V617F was shown to have arisen<br/>by acquired uniparental disomy (UPD) and examination of two cases with V617F plus either KIT<br/>D816V or BCR-ABL demonstrated that the mutations had arisen in independent clones.<br/><br/>(ii) In vitro assays to predict imatinib sensitivity. Haemopoietic colony and liquid cultures were<br/>used to determine if peripheral blood or bone marrow cells from atypical MPN cases (n=200) were<br/>sensitive to imatinib. Of those that responded in one or both cultures (n=185) some had known<br/>abnormalities of PDGFRA or PDGFRB, but a significant minority proved negative for all molecular tests<br/>suggesting the presence of uncharacterised imatinib-sensitive mutations.<br/><br/>(iii) V617F as a marker of response to therapy. JAK2 V617F was used as a molecular marker to<br/>monitor the response of PV patients (n=21) to therapy with imatinib and interferon-?. Neither<br/>therapy eradicated V617F but there was a modest reduction in %V617F which correlated with<br/>haematological response. By contrast, in those patients that did not respond (n=13) the %V617F<br/>marginally increased.<br/><br/>(iv) Genetic predisposition to MPN. Whilst investigating the possible contribution of JAK2 single<br/>nucleotide polymorphisms to the phenotypic diversity associated with V617F, marked skewing of<br/>alleles associated with the mutation was observed. Further investigation revealed that V617Fassociated<br/>disease is strongly associated with a specific constitutional JAK2 haplotype, designated<br/>46/1, in all three disease entities compared to healthy controls (PV, n=192, P=2.9x10-16; ET, n=78,<br/>P=8.2x10-9 and MF, n=41, P=8.0x10-5). Furthermore, allele-specific PCR demonstrated that V617F<br/>specifically arises on the 46/1 allele in most cases. The 46/1 JAK2 haplotype thus predisposes to the<br/>development of V617F associated MPNs (OR=3.7; 95% CI 3.1-4.3) and provides a model whereby a<br/>constitutional genetic factor is associated with an increased risk of acquiring a specific somatic<br/>mutation."]},{"key":"dc:format","label":"Dc Format","values":["text"]},{"key":"dc:title","label":"Title","values":["The molecular pathogenesis of myeloproliferative neoplasms"]}]}],"canonical_facts":{"dc:contributor.advisor":["Cross, Nicholas"],"dc:creator":["Jones, Amy Victoria"],"dc:date":["2010-06"],"dc:date.issued":["2010-06"],"dc:description.abstract":["Myeloproliferative neoplasms (MPNs) are a heterogeneous group of haematological stem cell<br/>malignancies characterised by proliferation of one or more cells of the myeloid lineage. The molecular<br/>investigation of MPN was revolutionized in 2005 by the finding that approximately 95% of cases with<br/>polycythaemia vera (PV) and 50-60% of cases of essential thrombocythaemia (ET) and primary<br/>myelofibrosis (PMF) are characterised by a single acquired mutation, JAK2 V617F. My study has<br/>focused on four principal areas:<br/><br/>(i) Involvement of V617F in other myeloid disorders. After developing sensitive methods to<br/>detect and quantify V617F, this mutation was identified in 17% of cases of atypical chronic myeloid<br/>leukaemia (17/99) as well as other atypical MPN, thus demonstrating that it was more widely<br/>involved in myeloid disorders that initially thought. Homozygosity of V617F was shown to have arisen<br/>by acquired uniparental disomy (UPD) and examination of two cases with V617F plus either KIT<br/>D816V or BCR-ABL demonstrated that the mutations had arisen in independent clones.<br/><br/>(ii) In vitro assays to predict imatinib sensitivity. Haemopoietic colony and liquid cultures were<br/>used to determine if peripheral blood or bone marrow cells from atypical MPN cases (n=200) were<br/>sensitive to imatinib. Of those that responded in one or both cultures (n=185) some had known<br/>abnormalities of PDGFRA or PDGFRB, but a significant minority proved negative for all molecular tests<br/>suggesting the presence of uncharacterised imatinib-sensitive mutations.<br/><br/>(iii) V617F as a marker of response to therapy. JAK2 V617F was used as a molecular marker to<br/>monitor the response of PV patients (n=21) to therapy with imatinib and interferon-?. Neither<br/>therapy eradicated V617F but there was a modest reduction in %V617F which correlated with<br/>haematological response. By contrast, in those patients that did not respond (n=13) the %V617F<br/>marginally increased.<br/><br/>(iv) Genetic predisposition to MPN. Whilst investigating the possible contribution of JAK2 single<br/>nucleotide polymorphisms to the phenotypic diversity associated with V617F, marked skewing of<br/>alleles associated with the mutation was observed. Further investigation revealed that V617Fassociated<br/>disease is strongly associated with a specific constitutional JAK2 haplotype, designated<br/>46/1, in all three disease entities compared to healthy controls (PV, n=192, P=2.9x10-16; ET, n=78,<br/>P=8.2x10-9 and MF, n=41, P=8.0x10-5). Furthermore, allele-specific PCR demonstrated that V617F<br/>specifically arises on the 46/1 allele in most cases. The 46/1 JAK2 haplotype thus predisposes to the<br/>development of V617F associated MPNs (OR=3.7; 95% CI 3.1-4.3) and provides a model whereby a<br/>constitutional genetic factor is associated with an increased risk of acquiring a specific somatic<br/>mutation."],"dc:format":["text"],"dc:identifier.uri":["https://eprints.soton.ac.uk/162665/1/Amy_final_version.pdf"],"dc:publisher.department":["Human Genetics (pre 2011 reorg)","School of Medicine"],"dc:publisher.institution":["University of Southampton"],"dc:relation.isreferencedby":["https://eprints.soton.ac.uk/162665/"],"dc:title":["The molecular pathogenesis of myeloproliferative neoplasms"],"dc:type":["Thesis"],"dc:type.qualificationlevel":["doctoral"],"dc:type.qualificationname":["Ph.D."]},"updated_at":"2026-07-24T04:36:17Z"}