Li Y, Peng G X, Gao Q Y, Li Y, Ye L, Li J P, Song L, Fan H H, Yang Y, Xiong Y Z, Wu Z J, Yang W R, Zhou K, Zhao X, Jing L P, Zhang F K, Zhang L
Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2018 May 14;39(5):414-419. doi: 10.3760/cma.j.issn.0253-2727.2018.05.014.
To evaluate the impact of the targeted next-generation sequencing (NGS) assay for difficult congenital anemias. Blood Disease Hospital Anemia Panel 2014 (BDHAP-2014) including 217 known genes of congenital anemias was developed. NGS and parental verification were performed for patients who were suspected diagnosed with congenital anaemia from August 2014 to July 2017. A total of 46 patients were enrolled in this study, the clinical suspection were 11 cases Fanconi anemia (FA), 8 cases congenital dyserythropoietic anemia (CDA), 6 cases congenital sideroblast anemia (CSA), 12 cases congenital hemolytic anemia (CHA), 1 case dyskeratosis congenital (DC), 4 cases iron-refractory iron deficiency anemia and 4 cases unexplained cytopenia (Uc), respectively. 28 (60.9%) of 46 patients became confirmed cases after targeted NGS, corresponding to 44 mutations of which 33 were new. 26(56.5%) patients with results of the assay matching to clinical suspection, including FA (5/11, 45.5%), CSA (6/6, 100.0%), CDA (3/8, 37.5%) and CHA (12/12, 100.0%). 2 (4.3%) cases not matching to clinical suspection, including dyskeratosis congenital (DC) was made in 1(2.2%) patients with suspected FA and familial hemophagocytic lymphohistiocytosis (FHL) was made in 1(2.2%) patients with suspected unexplained cytopenia (Uc). In 12 CHA patients, the hemolytic type was further clarified by the NGS. The remaining 18 cases were not clearly diagnosed. Targeted NGS assay is of major impact on congenital anemias. The assay should be used routinely in congenital anemias.
评估靶向新一代测序(NGS)检测对疑难先天性贫血的影响。开发了包含217个先天性贫血已知基因的血液病医院贫血检测板2014(BDHAP - 2014)。对2014年8月至2017年7月疑似诊断为先天性贫血的患者进行了NGS检测和父母验证。本研究共纳入46例患者,临床疑似诊断分别为11例范可尼贫血(FA)、8例先天性红细胞生成异常性贫血(CDA)、6例先天性铁粒幼细胞贫血(CSA)、12例先天性溶血性贫血(CHA)、1例先天性角化不良(DC)、4例铁难治性缺铁性贫血和4例不明原因血细胞减少(Uc)。46例患者中有28例(60.9%)经靶向NGS检测后确诊,共发现44个突变,其中33个为新突变。26例(56.5%)患者的检测结果与临床疑似诊断相符,包括FA(5/11,45.5%)、CSA(6/6,100.0%)、CDA(3/8,37.5%)和CHA(12/12,100.0%)。2例(4.3%)患者的检测结果与临床疑似诊断不符,包括1例疑似FA患者被诊断为先天性角化不良(DC)(1/2.2%),1例疑似不明原因血细胞减少(Uc)患者被诊断为家族性噬血细胞性淋巴组织细胞增生症(FHL)(1/2.2%)。在12例CHA患者中,通过NGS进一步明确了溶血类型。其余18例未明确诊断。靶向NGS检测对先天性贫血有重要影响。该检测应在先天性贫血中常规使用。