Myeloproliferative and lymphoproliferative disorders: State of the art

Hematol Oncol. 2020 Apr;38(2):121-128. doi: 10.1002/hon.2701. Epub 2019 Dec 27.

Abstract

Myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are clonal disorders complicated mainly by vascular events and transformation to myelofibrosis (for PV and ET) or leukemia. Although secondary malignancies, in particular, lymphoproliferative disorders (LPNs), are rare, they occur at a higher frequency than found in the general population, and there has been recent scientific discussion regarding a hypothetical relationship between treatment with JAK inhibitors in MPN and the risk of development of LPN. This has prompted increased interest regarding the coexistence of MPN and LPN. This review focuses on the role of JAK2 and the JAK/STAT pathway in MPN and LPN, whether there is a role for the genetic background in the occurrence of both MPN and LPN and whether there is a role for cytoreductive drugs in the occurrence of both MPN and LPN. Furthermore, whether an increased risk of lymphoma development is limited to patients who receive the JAK inhibitor ruxolitinib, is a more general phenomenon that occurs following JAK1/2 inhibition or is associated with preferential JAK1 or JAK2 targeting is discussed.

Keywords: JAK2; JAK inhibitors; JAK/STAT pathway; lymphoproliferative disorders; myeloproliferative neoplasms; ruxolitinib.

Publication types

  • Review

MeSH terms

  • Humans
  • Janus Kinase 1 / antagonists & inhibitors
  • Janus Kinase 1 / genetics*
  • Janus Kinase 2 / antagonists & inhibitors
  • Janus Kinase 2 / genetics*
  • Lymphoproliferative Disorders / complications
  • Lymphoproliferative Disorders / drug therapy
  • Lymphoproliferative Disorders / genetics
  • Lymphoproliferative Disorders / pathology*
  • Mutation*
  • Myeloproliferative Disorders / complications
  • Myeloproliferative Disorders / drug therapy
  • Myeloproliferative Disorders / genetics
  • Myeloproliferative Disorders / pathology*
  • Prognosis
  • Protein Kinase Inhibitors / therapeutic use*

Substances

  • Protein Kinase Inhibitors
  • JAK1 protein, human
  • JAK2 protein, human
  • Janus Kinase 1
  • Janus Kinase 2

Grants and funding