JAK2 V617F: The most common driver mutation in MPNs. Variant Allele Frequency (VAF) helps distinguish between phenotypes and assess biological drive.
Variant Allele Frequency (%)
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Evaluating patients with suspected Myeloproliferative Neoplasms (MPN).
Interpreting VAF (Variant Allele Frequency) in the context of Polycythemia Vera (PV), Essential Thrombocythemia (ET), or Primary Myelofibrosis (PMF).
Distinguishing clonal MPN from secondary/reactive erythrocytosis or thrombocytosis.
Patient Population
Patients presenting with elevated haemoglobin, haematocrit, or platelet counts of unclear etiology.
Section 2
Formula & Logic
JAK2 V617F Positivity Rates
Condition
Prevalence (%)
Polycythemia Vera (PV)
> 95%
Essential Thrombocythemia (ET)
50 - 60%
Primary Myelofibrosis (PMF)
50 - 60%
Secondary Polycythemia
0%
Low VAF (CHIP)
A very low VAF (< 1-2%) in an otherwise healthy individual might represent Clonal Hematopoiesis of Indeterminate Potential (CHIP) rather than a definitive MPN.
Section 3
Pearls/Pitfalls
VAF and Phenotype
Higher VAF (> 50%) is more common in PV and PMF, often reflecting homozygous mutations due to uniparental disomy. Lower VAF is typically seen in ET.
Triple Negative MPN
If JAK2 V617F is negative in suspected ET or PMF, test for CALR (Calreticulin) and MPL mutations. If all three are negative, the patient is "Triple Negative".
Section 4
Evidence Appraisal
Guidelines
Somatic mutations of calreticulin in myeloproliferative neoplasms.