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Camargo R, de Castro Moreira Dos Santos A, Cândido Guido B, Lemos Mendanha Cavalcante L, Silva Dias AC, Mendonça de Pontes R, Magalhães Furtado F, Feitosa Salviano C, Tiziani V, Martins Córdoba JC, Quezado Magalhães IM. A sensitive and inexpensive high-resolution melting-based testing algorithm for diagnosis of transient abnormal myelopoiesis and myeloid leukemia of Down syndrome. Pediatr Blood Cancer 2022; 69:e29866. [PMID: 35731576 DOI: 10.1002/pbc.29866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 11/08/2022]
Abstract
Patients with Down syndrome (DS) are commonly affected by a pre-leukemic disorder known as transient abnormal myelopoiesis (TAM). This condition usually undergoes spontaneous remission within the first 2 months after birth; however, in children under 5, 20%-30% of cases evolve to myeloid leukemia of Down syndrome (ML-DS). TAM and ML-DS are caused by co-operation between trisomy 21 and acquired mutations in the GATA1 gene. Currently, only next-generation sequencing (NGS)-based methodologies are sufficiently sensitive for diagnosis in samples with small GATA1 mutant clones (≤10% blasts). Alternatively, this study presents research on a new, fast, sensitive, and inexpensive high-resolution melting (HRM)-based diagnostic approach that allows the detection of most cases of GATA1 mutations, including silent TAM. The algorithm first uses flow cytometry for blast count, followed by HRM and Sanger sequencing to search for mutations on exons 2 and 3 of GATA1. We analyzed 138 samples of DS patients: 110 of asymptomatic neonates, 10 suspected of having TAM, and 18 suspected of having ML-DS. Our algorithm enabled the identification of 33 mutant samples, among them five cases of silent TAM (5/110) and seven cases of ML-DS (7/18) with blast count ≤10%, in which GATA1 alterations were easily detected by HRM. Depending on the type of genetic variation and its location, our methodology reached sensitivity similar to that obtained by NGS (0.3%) at a considerably reduced time and cost, thus making it accessible worldwide.
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Affiliation(s)
- Ricardo Camargo
- Laboratório de Pesquisa Translacional, Hospital da Criança de Brasília José Alencar, Brasília, Brazil
| | - Agenor de Castro Moreira Dos Santos
- Laboratório de Pesquisa Translacional, Hospital da Criança de Brasília José Alencar, Brasília, Brazil.,Laboratório Central de Saúde Pública do Distrito Federal, Brasília, Brazil
| | - Bruna Cândido Guido
- Laboratório de Pesquisa Translacional, Hospital da Criança de Brasília José Alencar, Brasília, Brazil
| | | | - Anna Carolina Silva Dias
- Laboratório de Pesquisa Translacional, Hospital da Criança de Brasília José Alencar, Brasília, Brazil
| | | | - Felipe Magalhães Furtado
- Laboratório de Pesquisa Translacional, Hospital da Criança de Brasília José Alencar, Brasília, Brazil
| | | | - Valdenize Tiziani
- Laboratório de Pesquisa Translacional, Hospital da Criança de Brasília José Alencar, Brasília, Brazil
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Borges MLRDR, Soares-Ventura EM, Liehr T, Marques-Salles TDJ. Minimally differentiated acute myeloid leukemia with ring/marker derived from chromosome 7 in a child with Down syndrome. Hematol Transfus Cell Ther 2019; 41:84-87. [PMID: 30793109 PMCID: PMC6371640 DOI: 10.1016/j.htct.2018.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 05/08/2018] [Indexed: 11/18/2022] Open
Affiliation(s)
- Maria Luiza Rocha da Rosa Borges
- Hospital Universitário Oswaldo Cruz, Recife, PE, Brazil; Faculdade de Ciências Médicas da Universidade de Pernambuco (FCM UPE), Recife, PE, Brazil
| | - Eliane Maria Soares-Ventura
- Hospital Universitário Oswaldo Cruz, Recife, PE, Brazil; Faculdade de Ciências Médicas da Universidade de Pernambuco (FCM UPE), Recife, PE, Brazil
| | - Thomas Liehr
- Institute of Human Genetics, Jena University Hospital, Jena, Germany
| | - Terezinha de Jesus Marques-Salles
- Hospital Universitário Oswaldo Cruz, Recife, PE, Brazil; Faculdade de Ciências Médicas da Universidade de Pernambuco (FCM UPE), Recife, PE, Brazil.
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