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Improving diagnostic precision, care and syndrome definitions using comprehensive next-generation sequencing for the inherited bone marrow failure syndromes.
- Source :
-
Journal of medical genetics [J Med Genet] 2015 Sep; Vol. 52 (9), pp. 575-84. Date of Electronic Publication: 2015 Jul 01. - Publication Year :
- 2015
-
Abstract
- Background: Phenotypic overlap among the inherited bone marrow failure syndromes (IBMFSs) frequently limits the ability to establish a diagnosis based solely on clinical features. >70 IBMFS genes have been identified, which often renders genetic testing prolonged and costly. Since correct diagnosis, treatment and cancer surveillance often depend on identifying the mutated gene, strategies that enable timely genotyping are essential.<br />Methods: To overcome these challenges, we developed a next-generation sequencing assay to analyse a panel of 72 known IBMFS genes. Cases fulfilling the clinical diagnostic criteria of an IBMFS but without identified causal genotypes were included.<br />Results: The assay was validated by detecting 52 variants previously found by Sanger sequencing. A total of 158 patients with unknown mutations were studied. Of 75 patients with known IBMFS categories (eg, Fanconi anaemia), 59% had causal mutations. Among 83 patients with unclassified IBMFSs, we found causal mutations and established the diagnosis in 18% of the patients. The assay detected mutant genes that had not previously been reported to be associated with the patient phenotypes. In other cases, the assay led to amendments of diagnoses. In 20% of genotype cases, the results indicated a cancer surveillance programme.<br />Conclusions: The novel assay is efficient, accurate and has a major impact on patient care.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
- Subjects :
- Anemia, Aplastic
Bone Marrow Diseases
Bone Marrow Failure Disorders
High-Throughput Nucleotide Sequencing methods
Humans
Mutation
Patient Care
Sensitivity and Specificity
Hemoglobinuria, Paroxysmal diagnosis
Hemoglobinuria, Paroxysmal genetics
Hemoglobinuria, Paroxysmal therapy
Sequence Analysis, DNA methods
Subjects
Details
- Language :
- English
- ISSN :
- 1468-6244
- Volume :
- 52
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of medical genetics
- Publication Type :
- Academic Journal
- Accession number :
- 26136524
- Full Text :
- https://doi.org/10.1136/jmedgenet-2015-103270