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From the Departments of Hematology,* Human Pathology and Oncology, and Experimental Pathology and Oncology,|| University of Florence, Florence, Italy; the Department of Hematology, Oncology, and Molecular Medicine, Istituto Superiore Sanità, Rome, Italy; and the Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
The abnormal megakaryocytopoiesis associated with idiopathic myelofibrosis (IM) plays a role in its pathogenesis. Because mice with defective expression of transcription factor GATA-1 (GATA-1low mutants) eventually develop myelofibrosis, we investigated the occurrence of GATA-1 abnormalities in IM patients. CD34+ cells were purified from 12 IM patients and 8 controls; erythroblasts and megakaryocytes were then obtained from unilineage cultures of CD34+ cells. Purified CD61+, GPA+, and CD34+ cells from IM patients contained levels of GATA-1, GATA-2, and FOG-1 mRNA, as well as of GATA-2 protein, that were similar to controls. In contrast, CD61+ cells from IM patients contained significantly reduced GATA-1 protein. Furthermore, 45% of megakaryocytes in biopsies from IM patients did not stain with anti-GATA-1 antibody, as compared to controls (2%), essential thrombocythemia (4%), or polycythemia vera (11%) patients. Abnormalities in immunoreactivity for FOG-1 were not found, and no mutations in GATA-1 coding sequences were found. The presence of GATA-1neg megakaryocytes in bone marrow biopsies was independent of the Val617Phe JAK2 mutation, making it unlikely that a downstream functional relationship exists. We conclude that megakaryocytes from IM patients have reduced GATA-1 content, possibly contributing to disease pathogenesis as in the GATA-1low mice and also representing a novel IM-associated marker.
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