Myelodysplastic Syndrome/Acute Myeloid Leukemia Arising in Idiopathic Erythrocytosis

The term “idiopathic erythrocytosis (IE)” is applied to those cases where a causal clinical or pathological event cannot be elucidated and likely reflects a spectrum of underlying medical and molecular abnormalities. The clinical course of a patient with IE is described manifesting as a persistent e...

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Main Authors: Stephen E. Langabeer, Eibhlin Conneally, Catherine M. Flynn
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2018/4378310
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author Stephen E. Langabeer
Eibhlin Conneally
Catherine M. Flynn
author_facet Stephen E. Langabeer
Eibhlin Conneally
Catherine M. Flynn
author_sort Stephen E. Langabeer
collection DOAJ
description The term “idiopathic erythrocytosis (IE)” is applied to those cases where a causal clinical or pathological event cannot be elucidated and likely reflects a spectrum of underlying medical and molecular abnormalities. The clinical course of a patient with IE is described manifesting as a persistent erythrocytosis with a low serum erythropoietin level, mild eosinophilia, and with evidence of a thrombotic event. The patient subsequently developed a myelodysplasic syndrome (MDS) and acute myeloid leukemia (AML), an event not observed in erythrocytosis patients other than those with polycythemia vera (PV). Application of a next-generation sequencing (NGS) approach targeted for myeloid malignancies confirmed wild-type JAK2 exons 12–15 and identified a common SH2B3 W262R single-nucleotide polymorphism associated with the development of hematological features of myeloproliferative neoplasms (MPNs). Further NGS analysis detected a CBL L380P mutated clone expanding in parallel with the development of MDS and subsequent AML. Despite the absence of JAK2, MPL exon 10, or CALR exon 9 mutations, a similarity with the disease course of PV/MPN was evident. A clonal link between the erythrocytosis and AML could be neither confirmed nor excluded. Future molecular identification of the mechanisms underlying IE is likely to provide a more refined therapeutic approach.
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spelling doaj-art-c21c487a59134de5961fa2b87cda76de2025-08-20T02:19:15ZengWileyCase Reports in Hematology2090-65602090-65792018-01-01201810.1155/2018/43783104378310Myelodysplastic Syndrome/Acute Myeloid Leukemia Arising in Idiopathic ErythrocytosisStephen E. Langabeer0Eibhlin Conneally1Catherine M. Flynn2Cancer Molecular Diagnostics, St. James’s Hospital, Dublin 8, IrelandDepartment of Haematology, St. James’s Hospital, Dublin 8, IrelandDepartment of Haematology, St. James’s Hospital, Dublin 8, IrelandThe term “idiopathic erythrocytosis (IE)” is applied to those cases where a causal clinical or pathological event cannot be elucidated and likely reflects a spectrum of underlying medical and molecular abnormalities. The clinical course of a patient with IE is described manifesting as a persistent erythrocytosis with a low serum erythropoietin level, mild eosinophilia, and with evidence of a thrombotic event. The patient subsequently developed a myelodysplasic syndrome (MDS) and acute myeloid leukemia (AML), an event not observed in erythrocytosis patients other than those with polycythemia vera (PV). Application of a next-generation sequencing (NGS) approach targeted for myeloid malignancies confirmed wild-type JAK2 exons 12–15 and identified a common SH2B3 W262R single-nucleotide polymorphism associated with the development of hematological features of myeloproliferative neoplasms (MPNs). Further NGS analysis detected a CBL L380P mutated clone expanding in parallel with the development of MDS and subsequent AML. Despite the absence of JAK2, MPL exon 10, or CALR exon 9 mutations, a similarity with the disease course of PV/MPN was evident. A clonal link between the erythrocytosis and AML could be neither confirmed nor excluded. Future molecular identification of the mechanisms underlying IE is likely to provide a more refined therapeutic approach.http://dx.doi.org/10.1155/2018/4378310
spellingShingle Stephen E. Langabeer
Eibhlin Conneally
Catherine M. Flynn
Myelodysplastic Syndrome/Acute Myeloid Leukemia Arising in Idiopathic Erythrocytosis
Case Reports in Hematology
title Myelodysplastic Syndrome/Acute Myeloid Leukemia Arising in Idiopathic Erythrocytosis
title_full Myelodysplastic Syndrome/Acute Myeloid Leukemia Arising in Idiopathic Erythrocytosis
title_fullStr Myelodysplastic Syndrome/Acute Myeloid Leukemia Arising in Idiopathic Erythrocytosis
title_full_unstemmed Myelodysplastic Syndrome/Acute Myeloid Leukemia Arising in Idiopathic Erythrocytosis
title_short Myelodysplastic Syndrome/Acute Myeloid Leukemia Arising in Idiopathic Erythrocytosis
title_sort myelodysplastic syndrome acute myeloid leukemia arising in idiopathic erythrocytosis
url http://dx.doi.org/10.1155/2018/4378310
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