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Lachover-Roth I, Peretz S, Zoabi H, Harel E, Livshits L, Filon D, Levin C, Koren A. Support Vector Machine-Based Formula for Detecting Suspected α Thalassemia Carriers: A Path toward Universal Screening. Int J Mol Sci 2024; 25:6446. [PMID: 38928152 PMCID: PMC11203927 DOI: 10.3390/ijms25126446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
The blood counts of α thalassemia carriers (α-thal) are similar to those of β thalassemia carriers, except for Hemoglobin A2 (Hb A2), which is not elevated. The objective of this study was to determine whether mathematical formulas are effective for detecting suspected α-thal. The data were obtained from the database of the prevention program for detecting couples at risk for having a child with hemoglobinopathy. Red Blood Cells (RBC) indices were analyzed using mathematical formulas, and the sensitivity and negative predictive value (NPV) were calculated. Among 1334 blood counts suspected of α-thal analyzed, only the Shine and Lal and the Support Vector Machine formulas revealed high sensitivity and NPV. Sensitivity was 85.54 and 99.33%, and NPV was 98.93 and 99.93%, respectively. Molecular defects were found in 291, and 81 had normal α genes. Molecular analysis was not performed in 962 of the samples. Based on these results, mathematical formulas incorporating one of these reliable formulas for detecting suspected α or β thalassemia carriers in the program of the automatic analyzers can flag these results, increase the awareness of the primary physicians about the carrier risk, and send an alert with a recommendation for further testing.
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Affiliation(s)
- Idit Lachover-Roth
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba 4428163, Israel;
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Sari Peretz
- Hematology Laboratory, Emek Medical Center, Afula 1834111, Israel; (S.P.); (H.Z.); (E.H.)
| | - Hiba Zoabi
- Hematology Laboratory, Emek Medical Center, Afula 1834111, Israel; (S.P.); (H.Z.); (E.H.)
| | - Eitam Harel
- Hematology Laboratory, Emek Medical Center, Afula 1834111, Israel; (S.P.); (H.Z.); (E.H.)
| | - Leonid Livshits
- Red Blood Cell Research Group, Vetsuisse Faculty, Institute of Veterinary Physiology, University of Zurich, 8057 Zürich, Switzerland;
- The Zurich Center for Integrative Human Physiology (ZIHP), 8057 Zürich, Switzerland
| | - Dvora Filon
- Hematology Division, Hadassah Medical Center, Jerusalem 9112001, Israel;
| | - Carina Levin
- Pediatric Hematology Unit, Research Laboratory, Emek Medical Center, Afula 1834111, Israel;
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3525422, Israel
| | - Ariel Koren
- Pediatric Hematology Unit, Research Laboratory, Emek Medical Center, Afula 1834111, Israel;
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Wu Q, Yu Y, Feng S, Fang B, Zheng R, Sun W, Zhao J. Secondary hemophagocytic syndrome in an acquired immunodeficiency syndrome and Alpha-thalassemia patient infected with Talaromyces marneffei: A case report and literature review. IDCases 2024; 36:e01954. [PMID: 38659622 PMCID: PMC11040128 DOI: 10.1016/j.idcr.2024.e01954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/24/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease characterized by a hyperinflammatory syndrome and impairment of multiple organ systems. Talaromycosis marneffei (TSM) is an opportunistic infection mostly found in immunosuppressed populations, such as those with acquired immunodeficiency syndrome (AIDS), and is prevalent in southern China. However, HLH secondary to TSM is extremely rare and has only been reported in isolated cases. A 30-year-old patient with recurrent high fever and progressive cytopenia was diagnosed with HLH secondary to disseminated TSM with AIDS and Alpha-thalassemia. The patient remained in sustained remission without recurrence after effective treatment with antifungals and glucocorticoids.
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Affiliation(s)
- Qingqing Wu
- Department of Hematology, Shaoxing Central Hospital, The Central Hospital of Shaoxing University, Shaoxing 312030, China
| | - Yixiu Yu
- Department of Hematology, Shaoxing Central Hospital, The Central Hospital of Shaoxing University, Shaoxing 312030, China
| | - Shenhong Feng
- Department of Hematology, Shaoxing Central Hospital, The Central Hospital of Shaoxing University, Shaoxing 312030, China
| | - Bingqian Fang
- Department of Hematology, Shaoxing Central Hospital, The Central Hospital of Shaoxing University, Shaoxing 312030, China
| | - Renzhi Zheng
- Department of Hematology, Shaoxing Central Hospital, The Central Hospital of Shaoxing University, Shaoxing 312030, China
| | - Weidong Sun
- Department of Hematology, Shaoxing Central Hospital, The Central Hospital of Shaoxing University, Shaoxing 312030, China
| | - Jianzhi Zhao
- Department of Hematology, Shaoxing Central Hospital, The Central Hospital of Shaoxing University, Shaoxing 312030, China
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Hansen NF, Wang X, Tegegn MB, Liu Z, Gouveia MH, Hill G, Lin JC, Okulosubo T, Shriner D, Thein SL, Mullikin JC. Random forest classifiers trained on simulated data enable accurate short read-based genotyping of structural variants in the alpha globin region at Chr16p13.3. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.27.568683. [PMID: 38076833 PMCID: PMC10705532 DOI: 10.1101/2023.11.27.568683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
In regions where reads don't align well to a reference, it is generally difficult to characterize structural variation using short read sequencing. Here, we utilize machine learning classifiers and short sequence reads to genotype structural variants in the alpha globin locus on chromosome 16, a medically-relevant region that is challenging to genotype in individuals. Using models trained only with simulated data, we accurately genotype two hard-to-distinguish deletions in two separate human cohorts. Furthermore, population allele frequencies produced by our methods across a wide set of ancestries agree more closely with previously-determined frequencies than those obtained using currently available genotyping software.
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Affiliation(s)
- Nancy F. Hansen
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Xunde Wang
- Sickle Cell Branch, National Heart, Lung and Blood Institute, NIH, Bethesda, MD 20892, USA
| | - Mickias B. Tegegn
- Sickle Cell Branch, National Heart, Lung and Blood Institute, NIH, Bethesda, MD 20892, USA
| | - Zhi Liu
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Mateus H. Gouveia
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Gracelyn Hill
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Jennifer C. Lin
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Temiloluwa Okulosubo
- Sickle Cell Branch, National Heart, Lung and Blood Institute, NIH, Bethesda, MD 20892, USA
| | - Daniel Shriner
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Swee Lay Thein
- Sickle Cell Branch, National Heart, Lung and Blood Institute, NIH, Bethesda, MD 20892, USA
| | - James C. Mullikin
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
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Costa-Júnior DAD, Santos APP, da Silva CM, Velloso-Rodrigues C. Growth Hormone/Insulin-Like Growth Factor 1 Axis Associated with Modifiers Factors in Children with Sickle Cell Anemia. Endocr Metab Immune Disord Drug Targets 2022; 22:954-962. [PMID: 35240969 DOI: 10.2174/1871530322666220303164029] [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: 08/05/2021] [Revised: 11/12/2021] [Accepted: 12/30/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sickle cell anemia is a disease that develops episodes of acute pain and multiple organ dysfunction that can affect the growth hormone/insulin-like growth factor 1 (GH/IGF-1) axis. The severity of sickle cell anemia is influenced by modifying factors, such as levels of fetal hemoglobin (HbF), the co-inheritance of alpha-thalassemia, or treatment with hydroxyurea. METHODS This cross-sectional study in children with sickle cell anemia evaluated bone age (BA), adult height prediction (AHP) using BA, a target height (TH) calculated as the mean SDS of the parents, and laboratory parameters. Children were grouped according to serum levels of HbF, co-inheritance of alpha-thalassemia, and hydroxyurea therapy. RESULTS The mean age of the 39 children was 8.2±2.2 years old. The average height was -0.75±0.30 SDS, and 10.3% (4/39) had short stature. Adjusted levels of IGF-1 or IGFBP-3 were significantly higher in children with sickle cell anemia on hydroxyurea treatment, in children with HbF levels >10%, and in those without alpha-thalassemia. Using SDS, the growth potential of children with sickle cell anemia in relation to their parents, calculated by the difference between AHP and TH, as well as the difference between children's height and their TH, were lower in children with co-inheritance of alpha-thalassemia Conclusion: The study showed an association between modifying factors and the GH/IGF-1 axis in children with sickle cell anemia. Additionally, the co-inheritance of alpha-thalassemia was associated with decreased height in these children when adjusted for their parents' height.
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Affiliation(s)
- Domício Antônio da Costa-Júnior
- Department of Medicine, Life Sciences Institute, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | | | | | - Cibele Velloso-Rodrigues
- Laboratory of Cellular Biology and Molecular Genetics, Department of Basic Life Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
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Rizo-de la Torre LDC, Rentería-López VM, Sánchez-López JY, Magaña-Torres MT, Ibarra-Cortés B, Perea-Díaz FJ. Molecular and Hematological Analysis of Alpha- and Beta-Thalassemia in a Cohort of Mexican Patients. Genet Test Mol Biomarkers 2021; 25:247-252. [PMID: 33734896 DOI: 10.1089/gtmb.2020.0276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Alpha- and beta-thalassemia are caused by reduced or absent synthesis of hemoglobin (Hb) subunits α and/or β. HBA2, HBA1, and HBB mutations are the main cause of thalassemias. The aim of this article is to analyze molecular and hematological features of α- and β-thal in a cohort of Mexican patients. Methods: One hundred forty-one thalassemia patients were studied. Peripheral blood was collected for blood cell count, electrophoresis, Hb quantification, and molecular testing. Molecular screening was performed by Gap-PCR, ARMS-PCR, Sanger sequencing, and MLPA. Results: Fifty-four patients had α-thal, 75 β-thal, and 12 patients were complex cases, we observed 13 α- and 18 β-thal alleles in 43 genotypes, -α3.7/αα and βCd39C>T/β were the most frequent. Four α-thal deletions (-Mex4 included HBA2 and HBA1, whereas (αα)Mex5, Mex6 and Mex7 involved MCS-R), a hereditary persistence of fetal hemoglobin-2 like (HPFH-2 like) deletion and six alleles not previously reported in Mexicans (α-59C>Tα, -α4.2, αPlasenciaα, β-32C>T, βInitCdA>C and βFSCd71/72+A) were identified. Conclusion: The observed alleles denote the high heterogeneity and multiple origin admixture of Mexican population. Hematological data are consistent with genotypes, variability in simple carriers, from asymptomatic forms to mild or moderate anemia, was ascertained. We emphasize the importance to consider hematological parameters to establish adequate molecular screening strategies.
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Affiliation(s)
- Lourdes Del Carmen Rizo-de la Torre
- División de Medicina Molecular, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Víctor Manuel Rentería-López
- División de Genética, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Josefina Yoaly Sánchez-López
- División de Genética, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - María Teresa Magaña-Torres
- División de Genética, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Bertha Ibarra-Cortés
- Instituto de Genética Humana "Dr Enrique Corona Rivera," Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Francisco Javier Perea-Díaz
- División de Genética, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
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