Identification of Adult Patients With Classical Dyskeratosis Congenita or Cryptic Telomere Biology Disorder by Telomere Length Screening Using Age-modified Criteria.


Journal

HemaSphere
ISSN: 2572-9241
Titre abrégé: Hemasphere
Pays: United States
ID NLM: 101740619

Informations de publication

Date de publication:
May 2023
Historique:
received: 12 09 2022
accepted: 08 03 2023
medline: 25 4 2023
pubmed: 25 4 2023
entrez: 25 04 2023
Statut: epublish

Résumé

Telomere biology disorders (TBD) result from premature telomere shortening due to pathogenic germline variants in telomere maintenance-associated genes. In adults, TBD are characterized by mono/oligosymptomatic clinical manifestations (cryptic TBD) contributing to severe underdiagnosis. We present a prospective multi-institutional cohort study where telomere length (TL) screening was performed in either newly diagnosed patients with aplastic anemia (AA) or if TBD was clinically suspected by the treating physician. TL of 262 samples was measured via flow-fluorescence in situ hybridization (FISH). TL was considered suspicious once below the 10th percentile of normal individuals (standard screening) or if below 6.5 kb in patients >40 years (extended screening). In cases with shortened TL, next generation sequencing (NGS) for TBD-associated genes was performed. The patients referred fell into 6 different screening categories: (1) AA/paroxysmal nocturnal hemoglobinuria, (2) unexplained cytopenia, (3) dyskeratosis congenita, (4) myelodysplastic syndrome/acute myeloid leukemia, (5) interstitial lung disease, and (6) others. Overall, TL was found to be shortened in 120 patients (n = 86 standard and n = 34 extended screening). In 17 of the 76 (22.4%) standard patients with sufficient material for NGS, a pathogenic/likely pathogenic TBD-associated gene variant was identified. Variants of uncertain significance were detected in 17 of 76 (22.4%) standard and 6 of 29 (20.7%) extended screened patients. Expectedly, mutations were mainly found in

Identifiants

pubmed: 37096215
doi: 10.1097/HS9.0000000000000874
pmc: PMC10121438
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e874

Informations de copyright

Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.

Déclaration de conflit d'intérêts

THB and FB have a long-ranging scientific collaboration with Repeat Dx., Vancouver, Canada. All the other authors have no conflicts of interest to disclose.

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Auteurs

Mareike Tometten (M)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Martin Kirschner (M)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Robert Meyer (R)

Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.
Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Matthias Begemann (M)

Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.
Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Insa Halfmeyer (I)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Margherita Vieri (M)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Kim Kricheldorf (K)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Angela Maurer (A)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Uwe Platzbecker (U)

Clinic for Hematology, Cellular Therapy, and Hemostaseology, University Hospital Leipzig, Germany.

Markus Radsak (M)

Department of Hematology, Medical Oncology, and Pneumology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

Philippe Schafhausen (P)

Department of Oncology, Hematology, and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Selim Corbacioglu (S)

Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Hospital Regensburg, Germany.

Britta Höchsmann (B)

Institute of Transfusion Medicine and Immunogenetics, University of Ulm, Germany.
Institute of Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Germany.

C Matthias Wilk (C)

Department of Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Switzerland.

Claas Hinze (C)

Department of Pediatric Rheumatology and Immunology, University Hospital Muenster, Germany.

Jörg Chromik (J)

Department of Medicine, Hematology and Oncology, Goethe-University, Frankfurt, Germany.

Michael Heuser (M)

Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.

Michael Kreuter (M)

Center for Interstitial and Rare Lung Diseases, Thoraxklinik, University of Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.
Academic Center for Pulmonary Medicine, Departments of Pneumology, Mainz University Medical Center, and of Pulmonary, Critical Care & Sleep Medicine, Marienhaus Clinic Mainz, Germany.

Steffen Koschmieder (S)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Jens Panse (J)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Susanne Isfort (S)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Ingo Kurth (I)

Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.
Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Tim H Brümmendorf (TH)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Fabian Beier (F)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Germany.

Classifications MeSH