A Rare Case of Polycythemia Vera Following Acute Undifferentiated Leukemia Remission

Polycythemia vera emerging eighteen years after acute myeloid leukemia diagnosis

“…A common feature of these four patients is the age at which PV becomes apparent with a range of 64–82 years ( Table 1 ). It may be speculated that intensive induction chemotherapy for AML and other hematological malignancies such as acute undifferentiated leukemia, acute lymphoblastic leukemia and diffuse large B-cell lymphoma [ 10 - 12 ] that result in ablation of the bone marrow microenvironment culminates in a niche compatible for pre-existing JAK2 V617F-positive stem cells with clonal potential to inhabit and expand resulting as apparent PV.…”

Can Polycythemia Vera evolve from Acute Myeloid Leukemia? A Case Report Showing a Simultaneous Minor JAK2 V617F Mutated Clone,

“…Previous studies reported in the literature speculated the possibility that intensive induction chemotherapy for AML, which results in the ablation of the BM microenvironment, may provide a suitable niche for pre-existing JAK2 V617F-positive stem cells with clonal potential to expand, resulting in the appearance of PV. [8][9][10][11][12] In summary, our report indicates that the coexistence of AML and MPNs could be possible beyond the natural history of myeloid malignancies, leading physicians to proceed to the diagnostic algorithm of MPN also in the presence of subtle clues that could suggest a "color change" towards myeloproliferative phenotype. The availability of sensitive diagnostic techniques such as ddPCR may provide the necessary diagnostic support to unravel these situations.…”

“…Despite progression to AML is a possible evolution of MPN, only a few cases of JAK2 V617F-positive PV developing while in long-term remission from AML have been previously described. [8][9][10][11][12] Here, we reported on a patient diagnosed with AML, who was treated with conventional 7+3 basedchemotherapy, achieved complete remission, and developed a JAK2-mutated PV two years after the end of consolidation treatment. We were interested in the biological features of the two diseases to define better the onset of the MPN clone and its kinetics.…”

“…Despite progression to AML is a possible evolution of MPN, only a few cases of JAK2 V617F-positive PV developing while in long-term remission from AML have been previously described. 8 – 12 …”

DNMT3A, TET2, and JAK2 mutations in polycythemia vera following long-term remission of secondary acute myeloid leukemia

“…On the contrary, PV/MPN developing after the diagnosis of AML is very rarely reported. In several reports, 10-12 it has been suggested that the JAK2 clone was present at the time of initial diagnosis of AML, expanded over time, and led to the development of PV, 3-5 years following achievement of remission of AML despite intensive chemotherapy given for the treatment of AML.…”