Glucose subversion by JAK2 V617F-positive MPNs. JAK2 V617F-positive cells exist within a tumor microenvironment consisting of multiple cell types, including fibroblasts, endothelial cells, bone lining cells, adipocytes, and neighboring non-mutant hematopoietic stem and progenitor cells. Surrounding immune cells (eg, dendritic cells, macrophages, and T cells) are thought to be overall immunosuppressive. Each cell type has unique metabolic demands. In this cartoon, an MPN cell is depicted using Pfkfb3, a rate-limiting enzyme in glycolysis, to increase glycolysis and usurp nutrients (glucose, fatty acids, amino acids) from the microenviroment. It is assumed that the relative glucose deprivation of surrounding cells leads to a competitive advantage for the MPN clone. HSC, hematopoietic stem/progenitor cells. Professional illustration by Somersault18:24.