Bibliographic Details
| Title: |
Case Report: First longitudinal study of a patient with CALR positive clonal hematopoiesis of indeterminate potential developing into pre-fibrotic myelofibrosis |
| Authors: |
Lasse Kjær, Vibe Skov, Morten Kranker Larsen, Tobias Idor Boklund, Morten Andersen, Maria Kefala, Trine A. Knudsen, Christina Schjellerup Eickhardt-Dalbøge, Thomas Stiehl, Johanne Gudmand-Høyer, Jordan Snyder, Morten Holmström, Mads H. Andersen, Johnny T. Ottesen, Christina Ellervik, Hans C. Hasselbalch |
| Source: |
Frontiers in Oncology, Vol 13 (2023) |
| Publisher Information: |
Frontiers Media S.A., 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| Subject Terms: |
case report, MPN, CALR, clonal hematopoiesis, myelofibrosis, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| More Details: |
Initial diagnosis of overt myeloproliferative neoplasms (MPNs) represents the juncture during clonal evolution when symptoms or complications prompt an afflicted individual to seek medical attention. In 30-40% of the MPN subgroups essential thrombocythemia (ET) and myelofibrosis (MF), somatic mutations in the calreticulin gene (CALR) are drivers of the disease resulting in constitutive activation of the thrombopoietin receptor (MPL). In the current study, we describe a healthy CALR mutated individual during a 12 year follow-up from initial identification of CALR clonal hematopoiesis of indeterminate potential (CHIP) to the diagnosis of pre-MF. The pre-diagnostic exponential development dynamics of the malignant clone demonstrated close correlation with the platelet counts, neutrophil-to-lymphocyte (NLR) ratio, and inversely correlated to hemoglobin and erythrocyte counts. Backward extrapolation of the growth rate indicated the potential for discovery of the malignant clone many years prior to presentation of overt disease, opening a window of opportunity for early treatment intervention. We did not find any additional mutations associated with MPNs and the current case report provides novel information regarding the development of a driver mutation and the association with blood cell counts prior to clinical manifestation of symptoms suggesting that pre-diagnostic dynamics may supplement future diagnostic criteria for early diagnosis and intervention in MPN patients. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2234-943X |
| Relation: |
https://www.frontiersin.org/articles/10.3389/fonc.2023.1176173/full; https://doaj.org/toc/2234-943X |
| DOI: |
10.3389/fonc.2023.1176173 |
| Access URL: |
https://doaj.org/article/ee792f216b2a41bf8a7c41cd3ed8d0cd |
| Accession Number: |
edsdoj.792f216b2a41bf8a7c41cd3ed8d0cd |
| Database: |
Directory of Open Access Journals |
