Patient 1 JAK2 exon 13 insertion/deletion mutation and endogenous erythroid colony formation assay. (A) Structural layout of the JAK2 kinase from N terminus to C terminus. Critical domains are labeled in red. The amino acid sequences of the pseudokinase (JH2) domain of JAK2WT, JAK2V617F, and JAK2ex13InDel are highlighted. Note the deletion of residues 583 to 586 in JAK2ex13InDel and insertion of an in-frame serine residue. Tyrosine 114 in the FERM domain is critical for interactions with cytokine receptors. (B) Trends in the patient’s blood counts in response to ruxolitinib and 5-azacitidine treatment. BID, twice daily; Eos, eosinophil; Hgb, hemoglobin; Plt, platelet; WBC, white blood cell. (C) Peripheral blood mononuclear cells from the patient and a healthy control were cultured in the absence or presence of graded concentrations of EPO. In the absence of EPO, 10 EECs were observed to grow out from patient-derived mononuclear cells. Numbers above bars represent number of colonies. (D) Patient-derived EECs were plucked and genotyped using JAK2 allele-specific polymerase chain reaction followed by fragment length analysis. Seven of 8 patient-derived EECs that were genotyped exhibited heterozygosity for JAK2ex13InDel. BFU-E, erythroid burst-forming units; WT, wild-type.