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Genetic analysis and clinical picture of severe congenital neutropenia in Israel
Author(s) -
Lebel Asaf,
Yacobovich Joanne,
Krasnov Tanya,
Koren Ariel,
Levin Carina,
Kaplinsky Chaim,
RavelVilk Shoshana,
Laor Ruth,
Attias Dina,
Barak Ayelet Ben,
Shtager Dalia,
Stein Jerry,
Kuperman Amir,
Miskin Hagit,
Dgany Orly,
Giri Neelam,
Alter Blanche P.,
Tamary Hannah
Publication year - 2015
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25251
Subject(s) - congenital neutropenia , neutropenia , medicine , population , oncology , pediatrics , environmental health , chemotherapy
Background The relative frequency of mutated genes among patients with severe congenital neutropenia (SCN) may differ between various ethnic groups. To date, few population‐based genetic studies have been reported. This study describes the genetic analysis of 32 Israeli patients with SCN. Procedures Clinical data were retrieved from the prospective Israeli Inherited Bone Marrow Failure Registry. Recruitment included living and deceased patients who were diagnosed between 1982 and 2012, for whom molecular diagnosis was performed. ELANE , HAX1 and G6PC3 genes were sequenced in all patients, and GFI‐1 and WAS genes were sequenced if other genes were wildtype. Results Eleven patients (34%) had heterozygous mutations in ELANE (10 kindreds), eight (25%) had homozygous mutations in G6PC3 (5 kindreds) and 13 (41%) had no detected mutations. No patients had mutations in HAX1 or WAS . Four of the eight patients with G6PC3 mutations had congenital anomalies. The probability of survival for all patients was 50% at age of 18. Deaths were mainly due to sepsis (5 patients, 4/5 not responding to G‐CSF, none with G6PC3 mutation). Two patients developed acute myelogenous leukemia (AML) and one myelodysplastic syndrome (MDS), none with G6PC3 mutation. Conclusions We found a unique pattern of SCN mutations in Israel with homozygous G6PC3 mutations in eight (25%) patients, the highest frequency described so far. HAX1 mutations, reported mainly in Sweden and Iran, were absent. Patients with G6PC3 mutations had congenital anomalies, appeared to have a better response to G‐CSF, and so far have not developed AML or MDS. Pediatr Blood Cancer 2015;62:103–108. © 2014 Wiley Periodicals, Inc.