Volume 43, Issue 6 pp. 1451-1457
ORIGINAL ARTICLE

Conformation sensitive gel electrophoresis for the detection of calreticulin mutations in BCR-ABL1-negative myeloproliferative neoplasms

Nur Atikah Zakaria

Nur Atikah Zakaria

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

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Norfifiana Alisa Rosle

Norfifiana Alisa Rosle

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

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Mat Jusoh Siti Asmaa

Mat Jusoh Siti Asmaa

School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

Universiti Sains Malaysia (USM)-RIKEN Interdisciplinary Collaboration for Advanced Sciences (URICAS), Penang, Malaysia

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Sudin Aziee

Sudin Aziee

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

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Mohd Yassim Haiyuni

Mohd Yassim Haiyuni

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

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Nurul Ameera Samat

Nurul Ameera Samat

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

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Azlan Husin

Azlan Husin

Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia

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Rosline Hassan

Rosline Hassan

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia

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Marini Ramli

Marini Ramli

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia

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Shafini Mohamed Yusoff

Shafini Mohamed Yusoff

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia

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Ibrahim Khidir Ibrahim

Ibrahim Khidir Ibrahim

Faculty of Medical Laboratory Sciences, Department of Haematology, Al-Neelain University, Khartoum, Sudan

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Hamid Ali Nagi Al-Jamal

Hamid Ali Nagi Al-Jamal

Diagnostic and Biomedicine, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Terengganu, Malaysia

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Muhammad Farid Johan

Corresponding Author

Muhammad Farid Johan

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia

Correspondence

Muhammad Farid Johan, Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

Email: [email protected]

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First published: 14 June 2021
Citations: 1

Nur Atikah Zakaria, Norfifiana Alisa Rosle and Mat Jusoh Siti Asmaa contributed equally to this study.

Abstract

Introduction

Calreticulin (CALR) mutations in myeloproliferative neoplasms (MPN) have been reported to be key markers in the molecular diagnosis, particularly in patients lacking JAK2 V617F mutation. In most current reports, CALR mutations were analysed by either allele-specific PCR (AS-PCR), or the more expensive quantitative real-time PCR, pyrosequencing and next-generation sequencing. Hence, we report the use of an alternative method, the conformation sensitive gel electrophoresis (CSGE) for the detection of CALR mutations in BCR-ABL1-negative MPN patients.

Methods

Forty BCR-ABL1-negative MPN patients’ DNA: 19 polycythemia vera (PV), 7 essential thrombocytosis (ET) and 14 primary myelofibrosis (PMF), were screened for CALR mutations by CSGE. PCR primers were designed to amplify sequences spanning between exons 8 and 9 to target the mutation hotspots in CALR. Amplicons displaying abnormal CSGE profiles by electrophoresis were directly sequenced, and results were analysed by BioEdit Sequence Alignment Editor v7.2.6. CSGE results were compared with AS-PCR and confirmed by Sanger sequencing.

Results

CSGE identified 4 types of mutations; 2 PMF patients with either CALR type 1 (c.1099_1150del52) or type 2 (c.1155_1156insTTGTC), 1 ET patient with nucleotide deletion (c.1121delA) and insertion (c.1190insA) and 1 PV patient with p.K368del (c.1102_1104delAAG) and insertion (c.1135insA) inframe mutations. Three patients have an altered KDEL motif at the C-terminal of CALR protein. In comparison, AS-PCR only able to detect two PMF patients with mutations, either type 1 and type 2.

Conclusion

CSGE is inexpensive, sensitive and reliable alternative method for the detection of CALR mutations in BCR-ABL1-negative MPN patients.

CONFLICT OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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