Background
Research into Philadelphia-negative chronic myeloproliferative neoplasms is heterogeneous. In addition, no systematization of studies of polycythemia vera (PV), essential thrombocythemia (ET) or primary myelofibrosis (PMF) have been carried out. The objective of this review is to characterize studies on
BCR-ABL1
-negative chronic myeloproliferative neoplasms and to compare the frequency of
JAK2, MPL
and
CALR
mutations in PV, ET and PMF.
Method
A systematic review of the scientific literature was conducted, as was meta-analysis with an ex-ante selection of protocol, according to phases of the PRISMA guide in three interdisciplinary databases. To guarantee reproducibility in the pursuit and retrieval of information, the reproducibility and methodological quality of the studies were evaluated by two researchers.
Results
Fifty-two studies were included, the majority having been carried out in the United States, China, Brazil and Europe. The frequency of the
JAK2V617F
mutation ranged from 46.7 to 100% in patients with PV, from 31.3 to 72.1% in patients with ET, and from 25.0 to 85.7% in those with PMF. The frequency of the
MPL
mutation was 0% in PV, from 0.9 to 12.5% in ET, and from 0 to 17.1% in PMF. The
CALR
mutation occurred at a frequency of 0.0% in PV, whereas in ET, it ranged from 12.6 to 50%, and in PMF, it ranged from 10 to 100%. The risk of this mutation presenting in PV is 3.0 times that found for ET and 4.0 times that found for PMF.
Conclusion
Given the specificity and reported high frequencies of the
JAK2V617F, MPL
and
CALR
mutations in this group of neoplasms, the diagnosis of these diseases should not be made on clinical and hematological characteristics alone but should include genetic screening of patients.