Skip to main content
Log in

Quantification of clonal hematopoiesis in polycythemia vera

  • Original Article
  • Published:
Virchows Archiv Aims and scope Submit manuscript

Abstract

Polycythemia vera (PV) is believed to represent a clonal trilineage myeloaccumulative hematopoietic disorder. This study was undertaken to estimate for the first time the proportion not only of the neoplastic clone but also of clonal and residual nonneoplastic CD34+ progenitor cells. Chromosomal abnormalities, including trisomy 8 or 9, are phenomena associated in about 20% of PV patients. Therefore, we screened peripheral blood (PB) mononuclear cells of PV patients in the chronic phase of the disease and looked for chromosomal abnormalities performing comparative genomic hybridization. Two of the ten patients revealed cytogenetic changes, including trisomy 8 or 9. To quantify the proportion of cytogenetic abnormal cells in these patients, we applied fluorescence in situ hybridization (FISH) technique on immunomagnetically enriched cell fractions. Ninety percent of the mononuclear cells and up to 79% of PB-derived CD34+ progenitor cells presented three signals for chromosome 8 or 9. The diagnostic value of FISH to detect trisomies in trephine biopsies was then tested in all patients under study. Although the probability to detect FISH signals in a certain section plane is reduced, constantly 10–15% of the cells revealed three signals. Concerning the CD34+ progenitor cell pool, a distinct nonclonal population exists in these patients. Our data underline the stem cell character of PV and additionally quantify the proportion of clonal CD34+ progenitor cells for the first time. The finding of a distinct, not aberrant, CD34+ progenitor cell population in chronic phase PV may offer perspectives in treatment of the disease. Finally, FISH analysis of bone marrow biopsies can be helpful to consolidate diagnosis of early PV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Amiel A, Gaber E, Manor Y, Fejgin M, Joseph-Lerner N, Ravid M, Lishner M (1995) Fluorescence in situ hybridization for the detection of trisomies 8 and 9 in polycythemia vera. Cancer Genet Cytogenet 79:153–156

    Article  PubMed  CAS  Google Scholar 

  2. Baxter EJ, Scott LM, Campbell PJ, East C, Fourouclas N, Swanton S, Vassiliou GS, Bench AJ, Boyd EM, Curtin N, Scott MA, Erber WN, Green AR (2005) Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders. Lancet 365:1054–1061

    PubMed  CAS  Google Scholar 

  3. Bench AJ, Nacheva EP, Champion KM, Green AR (1998) Molecular genetics and cytogenetics of myeloproliferative disorders. Bailliere's Clin Haematol 11:819–848

    Article  CAS  Google Scholar 

  4. Bhatia R, McGlave PB, Dewald GW, Blazar BR, Verfaillie CM (1995) Abnormal function of the bone marrow microenvironment in chronic myelogenous leukemia: role of malignant stromal macrophages. Blood 85:3636–3645

    PubMed  CAS  Google Scholar 

  5. Busson M, Romana S, Khac FN, Bernard O, Berger R (2004) Cryptic translocations involving chromosome 20 in polycythemia vera. Ann Genet 47:365–371

    PubMed  Google Scholar 

  6. Carneskog J, Kutti J, Wadenvik H, Lundberg PA, Lindstedt G (1998) Plasma erythropoietin by high-detectability immunoradiometric assay in untreated and treated patients with polycythaemia vera and essential thrombocythaemia. Eur J Haematol 60:278–282

    Article  PubMed  CAS  Google Scholar 

  7. Cashman J, Henkelman D, Humphries K, Eaves C, Eaves A (1983) Individual BFU-E in polycythemia vera produce both erythropoietin dependent and independent progeny. Blood 61:876–884

    PubMed  CAS  Google Scholar 

  8. Champion KM, Gilbert JG, Asimakopoulos FA, Hinshelwood S, Green AR (1997) Clonal haemopoiesis in normal elderly women: implications for the myeloproliferative disorders and myelodysplastic syndromes. Br J Haematol 97:920–926

    Article  PubMed  CAS  Google Scholar 

  9. Florensa L, Besses C, Zamora L, Bellosillo B, Espinet B, Serrano S, Woessner S, Sole F (2004) Endogenous erythroid and megakaryocytic circulating progenitors, HUMARA clonality assay, and PRV-1 expression are useful tools for diagnosis of polycythemia vera and essential thrombocythemia. Blood 103:2427–2428

    Article  PubMed  CAS  Google Scholar 

  10. Gale RE, Fielding AK, Harrison CN, Linch DC (1997) Acquired skewing of X-chromosome inactivation patterns in myeloid cells of the elderly suggests stochastic clonal loss with age. Br J Haematol 98:512–519

    Article  PubMed  CAS  Google Scholar 

  11. Gilbert HL, Acharya J, Pearson TC (1998) Implications for the use of X-chromosome inactivation patterns and their relevance to the myeloproliferative disorders. Eur J Haematol 61:282–283

    PubMed  CAS  Google Scholar 

  12. Goldman JM (2005) A unifying mutation in chronic myeloproliferative disorders. N Engl J Med 352:1744–1746

    Article  PubMed  CAS  Google Scholar 

  13. Herishanu Y, Lishner M, Bomstein Y, Kitay-Cohen Y, Fejgin MD, Gaber E, Amiel A (2001) Comparative genomic hybridization in polycythemia vera and essential thrombocytosis patients. Cancer Genet Cytogenet 128:154–157

    Article  PubMed  CAS  Google Scholar 

  14. James C, Ugo V, Le Couedic JP, Staerk J, Delhommeau F, Lacout C, Garcon L, Raslova H, Berger R, Bennaceur-Griscelli A, Villeval JL, Constantinescu SN, Casadevall N, Vainchenker W (2005) A unique clonal JAK2 mutation leading to constitutive signalling causes polycythaemia vera. Nature 434:1144–1148

    Article  PubMed  CAS  Google Scholar 

  15. Jones AV, Kreil S, Zoi K, Waghorn K, Curtis C, Zhang L, Score J, Seear R, Chase AJ, Grand FH, White H, Zoi C, Loukopoulos D, Terpos E, Vervessou EC, Schultheis B, Emig M, Ernst T, Lengfelder E, Hehlmann R, Hochhaus A, Oscier D, Silver RT, Reiter A, Cross NC (2005) Widespread occurrence of the JAK2 V617F mutation in chronic myeloproliferative disorders. Blood [Epub ahead of print]

  16. Kaushansky K (2005) On the molecular origins of the chronic myeloproliferative disorders: it all makes sense. Blood 105:4187–4190

    Article  PubMed  CAS  Google Scholar 

  17. Knuutila S, Armengol G, Bjorkqvist AM, el-Rifai W, Larramendy ML, Monni O, Szymanska J (1998) Comparative genomic hybridization study on pooled DNAs from tumors of one clinical–pathological entity. Cancer Genet Cytogenet 100:25–30

    Article  PubMed  CAS  Google Scholar 

  18. Kralovics R, Buser AS, Teo SS, Coers J, Tichelli A, van der Maas AP, Skoda RC (2003) Comparison of molecular markers in a cohort of patients with chronic myeloproliferative disorders. Blood 102:1869–1871

    Article  PubMed  CAS  Google Scholar 

  19. Kralovics R, Passamonti F, Buser AS, Teo SS, Tiedt R, Passweg JR, Tichelli A, Cazzola M, Skoda RC (2005) A gain-of-function mutation of JAK2 in myeloproliferative disorders. N Engl J Med 352:1779–1790

    Article  PubMed  CAS  Google Scholar 

  20. Kralovics R, Stockton DW, Prchal JT (2003) Clonal hematopoiesis in familial polycythemia vera suggests the involvement of multiple mutational events in the early pathogenesis of the disease. Blood 102:3793–3796

    Article  PubMed  CAS  Google Scholar 

  21. Levine RL, Wadleigh M, Cools J, Ebert BL, Wernig G, Huntly BJ, Boggon TJ, Wlodarska I, Clark JJ, Moore S, Adelsperger J, Koo S, Lee JC, Gabriel S, Mercher T, D'Andrea A, Frohling S, Dohner K, Marynen P, Vandenberghe P, Mesa RA, Tefferi A, Griffin JD, Eck MJ, Sellers WR, Meyerson M, Golub TR, Lee SJ, Gilliland DG (2005) Activating mutation in the tyrosine kinase JAK2 in polycythemia vera, essential thrombocythemia, and myeloid metaplasia with myelofibrosis. Cancer Cell 7:387–397

    Article  PubMed  CAS  Google Scholar 

  22. Lichter P, Joos S, Bentz M, Lampel S (2000) Comparative genomic hybridization: uses and limitations. Semin Hematol 37:348–357

    Article  PubMed  CAS  Google Scholar 

  23. Messora C, Bensi L, Vecchi A, Longo R, Giacobbi F, Temperani P, Bevini M, Emilia G, Sacchi S (1994) Cytogenetic conversion in a case of polycythaemia vera treated with interferon-alpha. Br J Haematol 86:402–404

    PubMed  CAS  Google Scholar 

  24. Najfeld V, Montella L, Scalise A, Fruchtman S (2002) Exploring polycythaemia vera with fluorescence in situ hybridization: additional cryptic 9p is the most frequent abnormality detected. Br J Haematol 119:558–566

    Article  PubMed  Google Scholar 

  25. Pellagatti A, Vetrie D, Langford CF, Gama S, Eagleton H, Wainscoat JS, Boultwood J (2003) Gene expression profiling in polycythemia vera using cDNA microarray technology. Cancer Res 63:3940–3944

    PubMed  CAS  Google Scholar 

  26. Spivak JL (2002) Polycythemia vera: myths, mechanisms, and management. Blood 100:4272–4290

    Article  PubMed  CAS  Google Scholar 

  27. Temerinac S, Klippel S, Strunck E, Roder S, Lubbert M, Lange W, Azemar M, Meinhardt G, Schaefer HE, Pahl HL (2000) Cloning of PRV-1, a novel member of the uPAR receptor superfamily, which is overexpressed in polycythemia rubra vera. Blood 95:2569–2576

    PubMed  CAS  Google Scholar 

  28. Westwood NB, Gruszka-Westwood AM, Atkinson S, Pearson TC (2001) Polycythemia vera: analysis of DNA from blood granulocytes using comparative genomic hybridization. Haematologica 86:464–469

    PubMed  CAS  Google Scholar 

  29. Westwood NB, Gruszka-Westwood AM, Pearson CE, Delord CF, Green AR, Huntly BJ, Lakhani A, McMullin MF, Pearson TC (2000) The incidences of trisomy 8, trisomy 9 and D20S108 deletion in polycythaemia vera: an analysis of blood granulocytes using interphase fluorescence in situ hybridization. Br J Haematol 110:839–846

    Article  PubMed  CAS  Google Scholar 

  30. Wickenhauser C, Perez F, Siebolts U, Lorenzen J, Varus E, Frimpong S, Thiele J (2003) Structural, antigenetic and transcriptional characteristics in peripheral blood CD34+ progenitor cells from polycythemia vera patients: evidence for delayed determination. Int J Oncol 23:437–443

    PubMed  CAS  Google Scholar 

  31. Wickenhauser C, Thiele J, Perez F, Varus E, Stoffel MS, Kvasnicka HM, Beelen DW, Schaefer UW (2002) Mixed chimerism of the resident macrophage population after allogeneic bone marrow transplantation for chronic myeloid leukemia. Transplantation 73:104–111

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Supported by the Cologne Fortune Foundation and by the Center for Molecular Medicine, University of Cologne (CMMC).

Declaration: all experiments comply with the laws of the Federal Republic of Germany and the European Union.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Claudia Wickenhauser.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Siebolts, U., Ates, M., Spitz, R. et al. Quantification of clonal hematopoiesis in polycythemia vera. Virchows Arch 447, 947–953 (2005). https://doi.org/10.1007/s00428-005-0047-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-005-0047-7

Keywords

Navigation