Journal
BRITISH JOURNAL OF HAEMATOLOGY
Volume 196, Issue 5, Pages 1149-1158Publisher
WILEY
DOI: 10.1111/bjh.17850
Keywords
Chronic myeloid malignancies; immunity; immunocompromise; immuno-oncology; JAK inhibitors
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Funding
- Cancer Research UK Advanced Clinician Scientist Fellowship
- UK National Institute for Health Research (NIHR) Biomedical Research Centre Haematology Subtheme
- NIHR BRC Senior Fellowship
- Blood Cancer UK Project Grant
- UK Medical Research Council (MRC) Clinician Scientist Fellowship
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BCR-ABL negative myeloproliferative neoplasms (MPNs) are chronic myeloid neoplasms initiated by gene mutations in hematopoietic stem cells. Dysregulation of the immune system plays a key role in MPNs, supporting clonal evolution and influencing vulnerability to infection. Targeting immune dysfunction is an important treatment strategy for MPNs.
Breakpoint cluster region-Abelson (BCR-ABL) negative myeloproliferative neoplasms (MPNs) are chronic myeloid neoplasms initiated by the acquisition of gene mutation(s) in a haematopoietic stem cell, leading to clonal expansion and over-production of blood cells and their progenitors. MPNs encompass a spectrum of disorders with overlapping but distinct molecular, laboratory and clinical features. This includes polycythaemia vera, essential thrombocythaemia and myelofibrosis. Dysregulation of the immune system is key to the pathology of MPNs, supporting clonal evolution, mediating symptoms and resulting in varying degrees of immunocompromise. Targeting immune dysfunction is an important treatment strategy. In the present review, we focus on the immune landscape in patients with MPNs - the role of inflammation in disease pathogenesis, susceptibility to infection and emerging strategies for therapeutic immune modulation. Further detailed work is required to delineate immune perturbation more precisely in MPNs to determine how and why vulnerability to infection differs between clinical subtypes and to better understand how inflammation results in a competitive advantage for the MPN clone. These studies may help shed light on new designs for disease-modifying therapies.
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