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Giambona A, Leto F, Cassarà F, Tartaglia V, Marchese G, Orlandi E, Cigna V, Picciotto F, Maggio A, Vinciguerra M. Early prenatal diagnosis of hemoglobinopathies by celocentesis is ready for use in routine clinical practice. Int J Lab Hematol 2023; 45:e19-e20. [PMID: 36059154 DOI: 10.1111/ijlh.13961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/18/2022] [Indexed: 01/18/2023]
Affiliation(s)
- Antonino Giambona
- UOSD Molecular Diagnosis of Rare Blood Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Filippo Leto
- UOSD Molecular Diagnosis of Rare Blood Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Filippo Cassarà
- UOSD Molecular Diagnosis of Rare Blood Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Viviana Tartaglia
- UOSD Molecular Diagnosis of Rare Blood Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Giuseppe Marchese
- UOSD Molecular Diagnosis of Rare Blood Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Emanuela Orlandi
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Valentina Cigna
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Francesco Picciotto
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Aurelio Maggio
- Unit of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis, and Rare Hematological Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - Margherita Vinciguerra
- UOSD Molecular Diagnosis of Rare Blood Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
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Vinciguerra M, Leto F, Cassarà F, Tartaglia V, Malacarne M, Coviello D, Cigna V, Orlandi E, Picciotto F, Cucinella G, Salzano E, Piccione M, Maggio A, Giambona A. Incidental Detection of a Chromosomal Aberration by Array-CGH in an Early Prenatal Diagnosis for Monogenic Disease on Coelomic Fluid. Life (Basel) 2022; 13:life13010020. [PMID: 36675969 PMCID: PMC9863495 DOI: 10.3390/life13010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/18/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Turner syndrome is a rare genetic condition in which a female is partly or completely missing an X chromosome. Signs and symptoms vary among those affected. In fetuses that survive at birth and without congenital malformations, the prognosis is usually positive, but it has high lethality in utero, especially in the first trimester of pregnancy. METHODS We report a case of monosomy X detected during a prenatal diagnosis for beta thalassemia on coelomic fluid (CF) at the VIII week of gestation. Beta globin gene analysis, whole genome amplification (WGA), quantitative fluorescent PCR and array comparative genomic hybridization (array-CGH) were performed on DNA extracted from CF. RESULTS A monoallelic pattern of all Short Tandem Repeats mapped on the X chromosome was found and array-CGH performed on WGA from a few fetal erythroblasts confirmed monosomy X. CONCLUSION This report underlines the importance of an early prenatal diagnosis and the countless potentialities of array-CGH that could make definition of molecular karyotype possible from a few fetal cells, unlike conventional cytogenetic techniques that require a greater cellular content. This is the first report of a molecular karyotype obtained from two cells selected by micromanipulation of CF and defined at such an early gestational age.
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Affiliation(s)
- Margherita Vinciguerra
- Unit of Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
- Correspondence: (M.V.); (A.G.); Tel.: +39-091-680-2770
| | - Filippo Leto
- Unit of Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Filippo Cassarà
- Unit of Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Viviana Tartaglia
- Unit of Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Michela Malacarne
- Laboratory of Human Genetics, Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Domenico Coviello
- Laboratory of Human Genetics, Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Valentina Cigna
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Emanuela Orlandi
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Francesco Picciotto
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Gaspare Cucinella
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Emanuela Salzano
- Medical Genetics Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, 90146 Palermo, Italy
| | - Maria Piccione
- Medical Genetics Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, 90146 Palermo, Italy
| | - Aurelio Maggio
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Antonino Giambona
- Unit of Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
- Correspondence: (M.V.); (A.G.); Tel.: +39-091-680-2770
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Giambona A, Leto F, Cassarà F, Tartaglia V, Campisi R, Campisi C, Cigna V, Mugavero E, Cucinella G, Orlandi E, Picciotto F, Maggio A, Vinciguerra M. Celocentesis for Early Prenatal Diagnosis in Couples at-Risk for β-Thalassemia and Sicilian (δβ) 0-Thalassemia. Hemoglobin 2022; 46:297-302. [PMID: 36876862 DOI: 10.1080/03630269.2023.2167659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The procedures commonly used for prenatal diagnosis (PND) of thalassemia are villocentesis or amniocentesis, respectively, at the 11th and 16th weeks of gestation. Their main limitation is essentially due to the late gestation week in which diagnosis is performed. The celomic cavity is accessible between the 7th and 9th weeks of gestation and it has been demonstrated that it contains embryonic erythroid precursor cells as a source of fetal DNA for earlier invasive PND of thalassemia and other monogenic diseases. In this study, we report the use of celomatic fluids obtained from nine women with high-risk pregnancies for Sicilian (δβ)0-thalassemia [(δβ)0-thal] deletion (NG_000007.3: g.64336_77738del13403) and β-thalassemia (β-thal). Fetal cells were isolated by a micromanipulator, and nested polymerase chain reaction (PCR) and short tandem repeats (STRs) analysis were performed. Prenatal diagnosis was successfully performed in all examined cases. One fetus was a compound heterozygote for (δβ)0- and β-thal, three fetuses were found to be carriers of β-thal, four fetuses carriers of a Sicilian δβ deletion, and one fetus without parental mutations. Accidentally, a rare case of paternal triploidy was observed. The genotypic analysis, carried out both by amniocentesis and on abortive tissue or after birth, showed concordance with results obtained on fetal celomic DNA. Our results unequivocally show that fetal DNA can be obtained by nucleated fetal cells present in the celomatic fluid and demonstrate, for the first time, that PND of Sicilian (δβ)0-thal and β-thal is feasible at an earlier time in pregnancy than other procedures.
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Affiliation(s)
- Antonino Giambona
- Unit of Molecular Diagnostics of Rare Hematological Diseases, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Filippo Leto
- Unit of Molecular Diagnostics of Rare Hematological Diseases, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Filippo Cassarà
- Unit of Molecular Diagnostics of Rare Hematological Diseases, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Viviana Tartaglia
- Unit of Molecular Diagnostics of Rare Hematological Diseases, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | | | | | - Valentina Cigna
- Unit of Fetal Medicine and Prenatal Diagnosis, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Elena Mugavero
- Unit of Fetal Medicine and Prenatal Diagnosis, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Gaspare Cucinella
- Unit of Fetal Medicine and Prenatal Diagnosis, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Emanuela Orlandi
- Unit of Fetal Medicine and Prenatal Diagnosis, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Francesco Picciotto
- Unit of Fetal Medicine and Prenatal Diagnosis, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Aurelio Maggio
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis and Rare Hematological Diseases, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
| | - Margherita Vinciguerra
- Unit of Molecular Diagnostics of Rare Hematological Diseases, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy
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Giambona A, Leto F, Cassarà F, Tartaglia V, Marchese G, Orlandi E, Cigna V, Picciotto F, Maggio A, Vinciguerra M. Early prenatal diagnosis of Hb Lepore Boston-Washington and β-thalassemia on fetal celomatic DNA. Int J Lab Hematol 2022; 44:796-802. [PMID: 35333433 DOI: 10.1111/ijlh.13837] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Analysis of fetal DNA in at risk couples for thalassemia is performed from fetal trophoblast or amniotic fluid cells. Although these procedures are in common use, the main limitation is essentially due to the late gestation week in which diagnosis is performed. The celomic cavity develops around 4 weeks of pregnancy within the extraembryonic mesoderm and contains embryonic erythroid precursor cells as a source of fetal DNA that can be used to perform invasive prenatal diagnosis. METHODS Celomatic fluids were obtained at 8 weeks of gestation in thirteen women with high-risk pregnancies. Twelve of these couples were at risk for Hb Lepore disease and β-thalassemia and one couple represented a rare case in which both parents were carriers of Hb Lepore Boston-Washington. Fetal cells were isolated by micromanipulator and nested polymerase chain reactions were performed. RESULTS The analysis was successfully performed in all examined cases. Two fetuses were found to have a compound heterozygosity for β-thalassemia and Hb Lepore Boston-Washington, three fetuses were found to be carriers of β-thalassemia, three fetuses of Hb Lepore, five were found without parental mutations. The genotypic analysis, carried out both by amniocentesis and on abortive tissue or after birth, showed concordance with results obtained on fetal celomic DNA. CONCLUSION Our results unequivocally show that fetal DNA can be obtained by nucleated fetal cells present in celomatic fluid and demonstrate for the first time that prenatal diagnosis of β-thalassemia and Hb Lepore may be feasible in an earlier time of pregnancy than other procedures.
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Affiliation(s)
- Antonino Giambona
- Unit of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Palermo, Italy
| | - Filippo Leto
- Unit of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Palermo, Italy
| | - Filippo Cassarà
- Unit of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Palermo, Italy
| | - Viviana Tartaglia
- Unit of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Palermo, Italy
| | - Giuseppe Marchese
- Unit of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Palermo, Italy
| | | | - Valentina Cigna
- Unit of Fetal Medicine and Prenatal Diagnosis, Palermo, Italy
| | | | - Aurelio Maggio
- Unit of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Palermo, Italy
| | - Margherita Vinciguerra
- Unit of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Palermo, Italy
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Giambona A, Vinciguerra M, Leto F, Cassarà F, Tartaglia V, Cigna V, Orlandi E, Picciotto F, Al Qahtani NH, Alsulmi ES, Almandil NB, AbdulAzeez S, Borgio JF, Maggio A. Celomic Fluid: Laboratory Workflow for Prenatal Diagnosis of Monogenic Diseases. Mol Diagn Ther 2022; 26:239-252. [PMID: 35175567 DOI: 10.1007/s40291-022-00577-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Celomic fluid can be considered as an ultra-filtrate of maternal serum, containing a high protein concentration, urea, and many other molecules. It is an important transfer interface and a reservoir of nutrients for the embryo. Celomic fluid contains fetal cells that can be used for prenatal diagnosis of monogenic diseases in an earlier gestational period than villocentesis and amniocentesis. OBJECTIVE The purpose of this study was to evaluate the characteristics of celomic fluid and to establish a workflow laboratory procedure for very early prenatal diagnosis of monogenic diseases. METHODS Three hundred and eighty-five celomatic fluids were collected between the seventh and tenth week of gestation. We sampled 1 mL of celomic fluid in all cases. The embryo-fetal erythroid precursor cells were selected by the anti-CD71 microbead method or by a direct micromanipulator pick-up on the basis of their morphology. We amplified the extracted DNA using a nested polymerase chain reaction. Primers for short tandem repeat amplification were used to perform a quantitative fluorescent polymerase chain reaction evaluation to control maternal contamination. RESULTS We observed maternal contamination in 95% of celomic fluids with a range between 5 and 100%. No fetal cells were observed in 0.78% of celomic fluids. The number of fetal cells ranged from a few units to several hundred. Isolation of embryo-fetal erythroblasts selected by the micromanipulator made diagnosis feasible in all cases. CONCLUSIONS The selection of fetal cells by a micromanipulator and nested polymerase chain reaction analysis made celomatic fluid suitable for early prenatal diagnosis of monogenic disorders even in the presence of high maternal contamination and few fetal cells. The procedure reported in this study provides the opportunity for the use of celomic fluid sampled by celocentesis as an alternative to chorionic villi sampling and amniocentesis, to allow invasive prenatal diagnosis at a very early stage of pregnancy.
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Affiliation(s)
- Antonino Giambona
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis, and Rare Hematological Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Via Trabucco 180, 90146, Palermo, Italy.
| | - Margherita Vinciguerra
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis, and Rare Hematological Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Via Trabucco 180, 90146, Palermo, Italy
| | - Filippo Leto
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis, and Rare Hematological Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Via Trabucco 180, 90146, Palermo, Italy
| | - Filippo Cassarà
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis, and Rare Hematological Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Via Trabucco 180, 90146, Palermo, Italy
| | - Viviana Tartaglia
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis, and Rare Hematological Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Via Trabucco 180, 90146, Palermo, Italy
| | - Valentina Cigna
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Emanuela Orlandi
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Francesco Picciotto
- Unit of Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Nourah H Al Qahtani
- Obstetrics and Gynecology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Eman S Alsulmi
- Obstetrics and Gynecology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Noor B Almandil
- Department of Clinical Pharmacy Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sayed AbdulAzeez
- Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - J Francis Borgio
- Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Aurelio Maggio
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis, and Rare Hematological Diseases, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia Cervello, Via Trabucco 180, 90146, Palermo, Italy
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Giambona A, Vinciguerra M, Leto F, Cassarà F, Cucinella G, Cigna V, Orlandi E, Piccione M, Picciotto F, Maggio A. Very early prenatal diagnosis of Cockayne's syndrome by coelocentesis. J OBSTET GYNAECOL 2022; 42:1524-1531. [PMID: 35006018 DOI: 10.1080/01443615.2021.2014429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cockayne's syndrome (CS) is a rare autosomal recessive multisystem disease characterised by early severe progression of symptoms. This study reports the feasibility of earlier prenatal diagnosis of CS by coelocentesis at 8 weeks of gestation respect to amniocentesis or villocentesis. Three couples at risk for CS asked to perform prenatal diagnosis by coelocentesis. Coelomic fluid was aspired from coelomic cavity in four singleton pregnancy at 8 weeks of gestation and 40 foetal cells were recovered by micromanipulator. Maternal DNA contamination was evaluated by quantitative fluorescent PCR (QF-PCR) and target regions of foetal DNA containing parental mutations of ERCC6 gene were amplified and sequenced. In all these cases, molecular analysis was possible. One foetus resulted affected of CS and the diagnosis was confirmed on placental tissue after voluntary abortion. In three cases, foetuses resulted carrier of a parental mutation and the results were confirmed after the birth. This study suggests that reliable prenatal diagnosis of CS could be performed using foetal cells present in coelomatic fluid in earlier pregnancy. Coelocentesis could be applied in prenatal diagnosis of CSs as well as for other monogenic diseases, at very early stage of pregnancy, if parental mutations are already known.Impact StatementWhat is already know on this subject? Previous studies utilising coelocentesis for prenatal determination of foetal sex reported variable success ranging from 58% to 95%, because of low total DNA content and presence of maternal cell contamination. This procedure has never been reported for early prenatal diagnosis at 8 weeks of gestation for rare genetically transmitted diseases such as Cockayne's syndrome.What do the results of this study add? This study demonstrates that coelomic fluid sampling combined with well-standardised laboratory procedures can be applied for prenatal diagnosis at eight weeks of gestation for any rare monogenic disease if molecular defects are known.What are the implications of these findings for clinical practice and/or further research? The findings of this study in at risk couples for monogenic diseases investigated by coelocentesis demonstrate that embryo-foetal cell selection from CF allows reliable and early prenatal diagnosis of diseases. This technique is attractive to parents because it provides prenatal diagnosis of genetic disease at least 4 weeks earlier than what can be achieved by the traditional procedures reducing anxiety of parents and provides the option for medical termination of affected cases at 8-10 weeks' gestation, which is less traumatic and safer than second-trimester surgical termination. Further research concerns the possibility to obtain foetal karyotype at eight weeks of gestation and the possibility of intrauterine corrective therapy.
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Affiliation(s)
- Antonino Giambona
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Margherita Vinciguerra
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Filippo Leto
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Filippo Cassarà
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Gaspare Cucinella
- Unit of Obstetrical and Gynecology, Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Valentina Cigna
- Unit of Obstetrical and Gynecology, Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Emanuela Orlandi
- Unit of Obstetrical and Gynecology, Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Maria Piccione
- Unit of Medical Genetics, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Francesco Picciotto
- Unit of Obstetrical and Gynecology, Fetal Medicine and Prenatal Diagnosis, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Aurelio Maggio
- Unit of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Hematological Diseases, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
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Makrydimas G, Damiani G, Jakil C, Cigna V, Orlandi M, Picciotto F, Schillaci G, Cassarà F, Vinciguerra M, Leto F, Giambona A, Maggio A, Nicolaides KH. Reply. Ultrasound Obstet Gynecol 2020; 56:790-791. [PMID: 33136321 DOI: 10.1002/uog.23137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- G Makrydimas
- Department of Obstetrics and Gynecology, Ioannina University Hospital, Ioannina, Greece
| | - G Damiani
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - C Jakil
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - V Cigna
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - M Orlandi
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Picciotto
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - G Schillaci
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Cassarà
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - M Vinciguerra
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Leto
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - A Giambona
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - A Maggio
- Campus of Hematology Franco and Piera Cutino, AOOR Villa Sofia Cervello, Palermo, Italy
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Makrydimas G, Damiani G, Jakil C, Cigna V, Orlandi M, Picciotto F, Schillaci G, Cassarà F, Vinciguerra M, Leto F, Giambona A, Maggio A, Nicolaides KH. Celocentesis for early prenatal diagnosis of hemoglobinopathy. Ultrasound Obstet Gynecol 2020; 56:672-677. [PMID: 32339311 DOI: 10.1002/uog.22059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Celocentesis is an invasive technique that can provide prenatal diagnosis of single-gene disorders, from as early as 7 weeks' gestation. The objective of this study was to examine the safety of celocentesis. METHODS In this prospective study, celocentesis was performed for prenatal diagnosis of hemoglobinopathy in 402 singleton pregnancies in which both parents were carriers of β-thalassemia or sickle cell disease trait. We assessed procedure-related maternal discomfort or pain, success of sampling and obtaining results, pregnancy outcome and postnatal follow-up. RESULTS First, celocentesis was carried out at a median gestational age of 8.6 (range, 6.9-9.9) weeks and celomic fluid was successfully aspirated in 99.8% of cases. Second, 67% of women had no or only mild discomfort, 18% had moderate discomfort, 12% had mild-to-moderate pain and 3% had severe pain. Third, prenatal diagnosis from analysis of the celomic fluid was successful in 93.8% cases, and in the last 121 cases, it was always successful. Fourth, in all cases of successful sampling and analysis of celomic fluid, the diagnosis was concordant with results obtained from additional prenatal or postnatal testing. Fifth, in addition to diagnosis of hemoglobinopathy, quantitative fluorescence polymerase chain reaction analysis, which was performed to evaluate maternal contamination using several markers for chromosomes X, Y, 21, 18 and 13, led to the accurate diagnosis of chromosomal aneuploidy. Sixth, in all cases of an affected fetus diagnosed by celocentesis in which the parents chose termination of pregnancy, this was carried out < 10 weeks' gestation. Seventh, in 97.1% (298/307) of the continuing pregnancies there was live birth, in seven (2.3%) there was miscarriage and in two (0.7%) there was loss to follow-up. Eighth, fetal abnormalities were diagnosed in three (1%) cases, including unilateral transverse amputation of the forearm, unilateral moderate hydronephrosis and small-bowel duplication. All neonates were examined by a pediatrician and were found to be phenotypically normal, except for the three cases with a prenatally diagnosed defect. CONCLUSIONS Celocentesis can be used for early prenatal diagnosis of genetic abnormalities, and the procedure-related risk of pregnancy complications appears to be low. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- G Makrydimas
- Department of Obstetrics and Gynecology, Ioannina University Hospital, Ioannina, Greece
| | - G Damiani
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - C Jakil
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - V Cigna
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - M Orlandi
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Picciotto
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - G Schillaci
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Cassarà
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - M Vinciguerra
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Leto
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - A Giambona
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - A Maggio
- Campus of Hematology Franco and Piera Cutino, AOOR Villa Sofia Cervello, Palermo, Italy
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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9
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Cannata M, Cassarà F, Vinciguerra M, Licari P, Passarello C, Leto F, Lo Pinto C, Pitrolo L, Ganci R, Maggio A, Giambona A. Double Heterozygosity for Hb Durham-N.C. ( HBB: c.344T>C) [β114(G16)Leu→Pro] and the IVS-I-110 ( HBB: c.93-21G>A) Causing a Severe β-Thalassemia Phenotype. Hemoglobin 2019; 43:210-213. [PMID: 31456457 DOI: 10.1080/03630269.2019.1655030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The evaluation of a 10-month-old girl of Sicilian origin with a clinical phenotype of severe thalassemia led to the identification of two β-globin gene defects, a β-thalassemia (β-thal), mutation at IVS-I-110 (HBB: c.93-21G>A) and a variant hemoglobin (Hb) mutation at codon 114 (HBB: c.344T>C) on the other allele, reported as Hb Durham-N.C. (also known as Hb Brescia) [β114(G16)Leu→Pro] in the HbVar database. A very low Hb level (Hb 3.5 g/dL), microcytosis [mean corpuscular volume (MCV) 63.2 fL] and hypocromia [mean corpuscular Hb (MCH) 19.6 pg], increased red blood cell (RBC) distribution width (RDW) (36.0%), higher reticulocytes (6.2%), anisocytosis, poikilocytosis, hypocromia, basophilic stippling and inclusion body formation, were present in the affected subject. Analysis of other family components showed the presence of HBB: c.93-21G>A defect in the mother and in her brother, while Hb Durham-N.C. was absent in all other relatives, thus, this mutation has arisen as a de novo defect. This is the first case described as a severe thalassemic phenotype in a compound heterozygote carrier of this unstable Hb and a common β-thalassemic allele. The important information gained from this case is that a rare dominant or recessive mutation may arise in every individual, even if this is a very rare event.
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Affiliation(s)
- Monica Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Margherita Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Paola Licari
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Cristina Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Leto
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Carmen Lo Pinto
- Department of Pediatrics, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Lorella Pitrolo
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Riccardo Ganci
- Department of Pediatrics, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Aurelio Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Antonino Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
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10
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Cassarà F, Vinciguerra M, Cannata M, Marchese G, Passarello C, Leto F, Maggio A, Giambona A. Phenotypic Evaluation of a Novel Nucleotide Substitution (HBD: c.442T>C) on the δ-Globin Gene. Hemoglobin 2018; 41:220-222. [PMID: 28840768 DOI: 10.1080/03630269.2017.1371036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
HBD: c.442T>C is a new mutation at the stop codon (TGA>CGA) of the δ-globin gene, which produces a new codon for arginine. This substitution causes a 51 nucleotides longer open reading frame determining the synthesis of a potential larger δ subunit, which is a probable target of mechanisms for the degradation of aberrant proteins as well as the defective synthesized mRNA molecules, and may also be rapidly degraded by a variety of RNA surveillance pathways. We identified this molecular defect in four patients: three women with a reduced HbA2 level and a 37-year-old male showing the typical phenotype of an α-thalassemia (α-thal) carrier with reduced values of red cell indices and normal HbA2 level (2.5%). The mutation on the δ-globin gene was found to have been coinherited with a β-globin gene defect leading to a normalized HbA2 level. These data support the necessity of investigating these cases at a molecular level, particularly if the partner is also a β-thalassemia (β-thal) carrier. The present data emphasizes the importance of a careful evaluation of correlation between genotypes resulting from DNA analysis and phenotypes, especially in cases of atypical hematological parameters, in order to carry out an adequate diagnostic process finalized to appropriate genetic counseling.
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Affiliation(s)
- Filippo Cassarà
- a Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Margherita Vinciguerra
- a Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Monica Cannata
- a Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Giorgio Marchese
- a Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Cristina Passarello
- a Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Leto
- a Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Aurelio Maggio
- a Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Antonino Giambona
- a Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
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11
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Vinciguerra M, Passarello C, Cassarà F, Leto F, Cannata M, Calvaruso G, Renda D, Maggio A, Giambona A. Coheredity of a new silent mutation: c.-29G>T, with a severe β-thal mutation in a patient with β-thalassemia intermediate. Int J Lab Hematol 2018; 40:e17-e20. [PMID: 29405650 DOI: 10.1111/ijlh.12777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 12/21/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M Vinciguerra
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Passarello
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Cassarà
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Leto
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Cannata
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Calvaruso
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - D Renda
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Maggio
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Giambona
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
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12
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Vinciguerra M, Cannata M, Cassarà F, Passarello C, Leto F, Calvaruso G, Renda D, Maggio A, Giambona A. HBB: c.316-125A>G and HBB: c.316-42delC: Phenotypic Evaluations of Two Rare Changes in the Second Intron of the HBB Gene. Hemoglobin 2017; 41:234-238. [DOI: 10.1080/03630269.2017.1397014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Margherita Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Monica Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Cristina Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Leto
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Giuseppina Calvaruso
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Disma Renda
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Aurelio Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Antonino Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
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13
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Vinciguerra M, Passarello C, Cassarà F, Leto F, Cannata M, Ferro E, Anzà D, Calvaruso G, Maggio A, Giambona A. Co-inheritance of HBB:c.-106G > C, a rare single nucleotide variation at position -56 relative to transcription initiation site, with other known mutations in the globin clusters. ACTA ACUST UNITED AC 2017; 23:368-372. [PMID: 29157184 DOI: 10.1080/10245332.2017.1403737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We performed molecular analysis to evaluate clinical implications of a rare nucleotide change, particularly when co-inherited with other known mutations in the globin clusters, in order to conduct an appropriate genetic counselling. METHODS Complete blood cell counts and high-performance liquid chromatography were the routine first level analysis for patients referred to our Hospital Center in Palermo to undergo the screening test for haemoglobinopathies. Sequencing analysis was the selected method for the phenotypic characterization, especially in case of new or very rare mutations in globin genes. RESULTS We report data of a rare single nucleotide variation at position -56 relative to transcription initiation site (NM_000518.4(HBB):c.-106G > C), identified in ten patients of Italian origin during the screening programme of the 'Sicilian population'. It was found in simple heterozygosity (n = 8), in association with beta haemoglobin variant Hb S (n = 1) and in heterozygosity with beta-thalassaemic allele IVS-I-1 G->A [(HBB):c.92 + 1G > A] and ααα anti3.7 rearrangement (n = 1). DISCUSSION Heterozygous subjects for this substitution showed normal haematological and electrophoretic features. Heterozygotes for this mutation and other defect in globin genes showed the classical phenotype of a healthy carrier, therefore it can be considered a benign variant that does not alter the production and function of haemoglobin. CONCLUSION This is another example of rare or new nucleotide variations whose identification and characterization is crucial in order to carry out appropriate genetic counselling to a potential risk couple.
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Affiliation(s)
- Margherita Vinciguerra
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Cristina Passarello
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Cassarà
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Leto
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Monica Cannata
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Elisa Ferro
- b Department of Human Pathology of adult and Developmental age, Gaetano Barresi , G Martino University Hospital , Messina , Italy
| | - Davide Anzà
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Giuseppina Calvaruso
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Aurelio Maggio
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Antonino Giambona
- a Department of Hematology for Rare Diseases. UOC of Haematology for rare diseases of Blood and Blood-forming Organs. Laboratory for Molecular Diagnosis of rare Diseases , Villa Sofia-Cervello Hospital , Palermo , Italy
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14
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Vitrano A, Sacco M, Rosso R, Quota A, Fiorino D, Oliva E, Gerardi C, Roccamo G, Spadola V, Filosa A, Tesé L, Calvaruso G, Pitrolo L, Mistretta L, Cassarà F, Di Maggio R, Maggio A. Longitudinal changes in LIC and other parameters in patients receiving different chelation regimens: Data from LICNET. Eur J Haematol 2017; 100:124-130. [PMID: 29094403 DOI: 10.1111/ejh.12989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The liver remains the primary site of iron storage, with liver iron concentration (LIC) being a strong surrogate of total body iron. MRI-R2 can accurately measure LIC. The LICNET (Liver Iron Cutino Network) was established to diagnostics of liver iron overload by MRI-R2 subjects with hemochromatosis in hematological disorders. The aims of the study were to look at variation in LIC measurements during time across different chelation regimens. METHODS This was a cross-sectional study of 130 patients attending 9 Italian centers participating in the LICNET. LIC comparisons over time (T0 and T1 ) were made using t test and/or Wilcoxon test. RESULTS LIC significantly decreased from MRI1 to MRI2 although at high variance (median change -0.8 mg Fe/g dw, range: -29.0 to 33.0; P = .011) and 7.7% of patients shifted from LIC values of high risk (>15 mg Fe/g dw) to an intermediate-risk category (7-15 mg Fe/g dw). Median change in LIC and correlation with serum ferritin levels (SF), during different chelation regimens, is reported. CONCLUSIONS These findings suggest as longitudinal variation in the LIC is possible, across all chelation regimens. It confirms as SF levels not always can be used for estimating changes in LIC.
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Affiliation(s)
- Angela Vitrano
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | - Massimiliano Sacco
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | | | | | | | - Esther Oliva
- A.O. "Bianchi-Melacrino- Morelli", Reggio Calabria, Italy
| | | | - Gaetano Roccamo
- Centro di Prevenzione e Cura delle Microcitemie, P.O. S'Agata Militello, Sant'Agata Militello, Italy
| | | | - Aldo Filosa
- U.O.D. Malattie Rare del Globulo Rosso, A.O.R.N. "A. Cardarelli", Napoli, Italy
| | - Lorenzo Tesé
- UOC Radiologia, AOOR Villa Sofia-Cervello, Palermo, Italy
| | - Giuseppina Calvaruso
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | - Lorella Pitrolo
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | - Laura Mistretta
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | - Filippo Cassarà
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | - Rosario Di Maggio
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy
| | - Aurelio Maggio
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy
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Vinciguerra M, Cassarà F, Cannata M, Renda D, Calvaruso G, Leto F, Passarello C, Maggio A, Giambona A. Phenotypic evaluations of HBB:c.93-23T>C, a nucleotide substitution in the IVS I nt 108 of β-globin gene. J Clin Pathol 2017; 71:jclinpath-2017-204651. [PMID: 28794124 DOI: 10.1136/jclinpath-2017-204651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/14/2017] [Accepted: 07/19/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Thalassaemia and variant haemoglobin are the most common severe monogenic disorders worldwide. AIMS To develop prenatal diagnosis programmes for the prevention of the most important haemoglobin disorders and identify healthy carriers of thalassaemia. METHODS Sequencing analysis was used to obtain complete data on gene structure and to correlate specific phenotypic expression with mutations, especially for new or very rare mutations in globin genes. RESULTS A rare single nucleotide variation, HBB:c.93-23T>C, located in nucleotide 108 of the first intervening sequence of the HBB gene, was identified. This variation was previously reported but its clinical significance was not known. Six heterozygous patients had this nucleotide variation and eight further cases co-inherited it together with other defects in the globin genes. Heterozygous subjects for this substitution showed normal haematological and electrophoretic features, whereas subjects who were compound heterozygotes for this mutation and another defect in globin genes showed the classic phenotype of a healthy carrier. CONCLUSION This nucleotide can be considered a single nucleotide polymorphism and not a thalassaemic mutation that reduces the production of haemoglobin. This is another example of a very rare nucleotide variation. Knowledge of this is important so that appropriate genetic counselling can be carried out of a couple potentially at risk, where one of the partners is a carrier of β-thalassaemia and the other is carrier of a nucleotide variation.
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Affiliation(s)
- Margherita Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Monica Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Disma Renda
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Giuseppina Calvaruso
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Leto
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Cristina Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Aurelio Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Antonino Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
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Vinciguerra M, Passarello C, Cassarà F, Leto F, Cannata M, Crivello A, Di Salvo V, Maggio A, Giambona A. Hb San Cataldo [β144(HC1)Lys→Thr; HBB: C.434A > C]: A New Hemoglobin Variant with Increased Affinity for Oxygen. Hemoglobin 2016; 40:223-7. [PMID: 27250824 DOI: 10.1080/03630269.2016.1182550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 59-year-old Italian woman came to our center for revaluation of a previous diagnosis of polycythemia vera. The patient presented with a lifelong history of polycythemia, no increase in white blood cells (WBCs) and platelets, and a negative bone marrow biopsy. Analysis of hemoglobin (Hb) fractions showed an abnormal fast moving Hb component. We aimed to determine if this variant was the cause of polycythemia in this patient. A complete blood count (CBC) was performed by an automated cell counter and Hb fractions were determined by high performance liquid chromatography (HPLC). Standard stability tests and oxygen affinity evaluation were also performed. Genomic DNA was extracted from peripheral blood leukocytes using the phenol chloroform method and the entire β-globin gene was analyzed by direct sequencing. At the hematological level, no anemia or hemolysis was observed but an abnormal Hb fraction was detected using cation exchange HPLC. Molecular analysis of the β-globin gene showed heterozygosity for an AAG > ACG substitution at codon 144, resulting in a Lys→Thr amino acid replacement. We demonstrated that this is a new Hb variant with increased oxygen affinity. Its altered physiology is caused by the reduction of 2,3-diphosphoglycerate (2,3-DPG) effects, due to an amino acid substitution in the central pocket near the C-terminal of the β chain. We called this new variant Hb San Cataldo for the native city of proband.
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Affiliation(s)
- Margherita Vinciguerra
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and.,b Department of Hematology and Rare Diseases , Unit for Molecular Diagnosis of Rare Diseases, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Cristina Passarello
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and.,b Department of Hematology and Rare Diseases , Unit for Molecular Diagnosis of Rare Diseases, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Cassarà
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and.,b Department of Hematology and Rare Diseases , Unit for Molecular Diagnosis of Rare Diseases, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Leto
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and.,b Department of Hematology and Rare Diseases , Unit for Molecular Diagnosis of Rare Diseases, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Monica Cannata
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and.,b Department of Hematology and Rare Diseases , Unit for Molecular Diagnosis of Rare Diseases, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Anna Crivello
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and.,b Department of Hematology and Rare Diseases , Unit for Molecular Diagnosis of Rare Diseases, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Veronica Di Salvo
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and
| | - Aurelio Maggio
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and.,b Department of Hematology and Rare Diseases , Unit for Molecular Diagnosis of Rare Diseases, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Antonino Giambona
- a Department of Hematology and Rare Diseases , Unit of Rare Diseases of Blood and Blood-Forming Organs, Villa Sofia-Cervello Hospital , Palermo , Italy and.,b Department of Hematology and Rare Diseases , Unit for Molecular Diagnosis of Rare Diseases, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital , Palermo , Italy
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Vinciguerra M, Passarello C, Leto F, Crivello A, Fustaneo M, Cassarà F, Cannata M, Maggio A, Giambona A. Coinheritance of a Rare Nucleotide Substitution on theβ-Globin Gene and Other Known Mutations in the Globin Clusters: Management in Genetic Counseling. Hemoglobin 2016; 40:231-5. [DOI: 10.1080/03630269.2016.1188400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vitrano A, Calvaruso G, Tesé L, Gioia F, Cassarà F, Campisi S, Butera F, Commendatore V, Rizzo M, Santoro V, Cigna V, Quota A, Bagnato S, Argento C, Fidone C, Schembari D, Gerardi C, Barbiera F, Bellisssima G, Giugno G, Polizzi G, Rosso R, Abbate G, Caruso V, Chiodi E, Gamberini MR, Giorgi B, Putti MC, Filosa A, De Ritis MR, Oliva E, Arcadi N, Fustaneo M, Mistretta L, Di Maggio R, Sacco M, Veronica DS, Giangreco A, Maggio A. Real-life experience with liver iron concentration R2 MRI measurement in patients with hemoglobinopathies: baseline data from LICNET. Eur J Haematol 2016; 97:361-70. [DOI: 10.1111/ejh.12740] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Angela Vitrano
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Giuseppina Calvaruso
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Lorenzo Tesé
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Francesco Gioia
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Filippo Cassarà
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | | | | | | | | | | | | | | | | | - Crocetta Argento
- U.O.S. di Talassemia Ospedale San Giovanni di Dio; Agrigento Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aldo Filosa
- U.O.D. Malattie Rare del Globulo Rosso; A.O.R.N. ‘A. Cardarelli’; Napoli Italy
| | | | - Esther Oliva
- A.O. ‘Bianchi-Melacrino-Morelli’; Reggio Calabria Italy
| | - Nicola Arcadi
- A.O. ‘Bianchi-Melacrino-Morelli’; Reggio Calabria Italy
| | - Maria Fustaneo
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Laura Mistretta
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Rosario Di Maggio
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Massimiliano Sacco
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Di Salvo Veronica
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Antonino Giangreco
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
| | - Aurelio Maggio
- Campus of Haematology Franco e Piera Cutino- A.O.O.R. ‘Villa Sofia-Cervello’; Palermo Italy
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Giambona A, Damiani G, Vinciguerra M, Jakil C, Cannata M, Cassarà F, Picciotto F, Schillaci G, Cigna V, Renda D, Leto F, Passarello C, Maggio A. Incidence of haemoglobinopathies in Sicily: the impact of screening and prenatal diagnosis. Int J Clin Pract 2015; 69:1129-38. [PMID: 25727926 DOI: 10.1111/ijcp.12628] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Haemoglobinopathies are a major public health problem in Sicily: it was estimated a frequency of 1/245 couples are at risk of haemoglobinopathies. This paper reviews legislative actions, prevention activities, carrier screening, genetic counselling, foetal sampling and laboratory methodology analysis evolution reporting the results of 30 years of prevention actions to assess the efficiency of our preventative programme in the control of haemoglobinopathies in Sicily. METHODS This programme consisted principally of five phases: legislative actions, public awareness campaign, carrier screening, genetic counselling and prenatal diagnosis. RESULTS These programmes have been very effective, which we can see from a greater public awareness of thalassaemia and its prevention in the target population furthermore by a marked decline in the incidence of thalassaemia major and sickle cell anaemia from 1 in 245 live births in the absence of prevention to 1 in 2000, with a reduction in about 85%. The residual cases were because of a conscious choice by expecting parents in relation to improved life expectancy as well as improved quality of life of the affected patients. CONCLUSION The study suggests that public health authorities should act and invest in a similar programme for prevention of thalassaemia, as well as in relation to the increased survival of patients and the consequent organ complications.
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Affiliation(s)
- A Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Damiani
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Jakil
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Picciotto
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Schillaci
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - V Cigna
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - D Renda
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Leto
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
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Vinciguerra M, Passarello C, Cassarà F, Leto F, Cannata M, Calvaruso G, Di Maggio R, Renda D, Maggio A, Giambona A. Co-heredity of silent CAP + 1570 T>C (HBB:c*96T>C) defect and severe β-thal mutation: a cause of mild β-thalassemia intermedia. Int J Lab Hematol 2015; 38:17-26. [PMID: 26418075 DOI: 10.1111/ijlh.12433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 08/05/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION During an intensive screening program aimed at identifying the healthy carriers of thalassemia and the couples at risk of bearing an affected fetus, a rare single nucleotide variation (SNV), CAP + 1570 T > C (HBB:c*96T > C), located 12 nucleotides upstream of the polyadenylation signal in 3'UTR of the beta globin gene was identified. It was previously reported as a β+ thalassemia mutation and later as a plain polymorphism. METHODS Genotype identification of globin gene mutations was carried out using sequencing analysis, GAP-PCR, and MLPA methods. RESULTS CAP + 1570 T > C (HBB:c*96T > C) was found in 39 heterozygotes, in one case in homozygous state and in thirteen cases of co-inheritance of this nucleotide substitution with other mutations in globin genes. Carriers of this mutation showed a 'silent' phenotype without appreciable microcytosis and hypochromia, so they cannot be differentiated from noncarrier individuals. Compound heterozygotes for this mutation and severe β-thal mutations showed a variable phenotype ranging from β-thal carrier to mild form of β-thalassemia intermedia, revealing new aspects and allowing to better understand the clinical implications of this nucleotide substitution that can be classified as a silent β-thalassemic defect. CONCLUSION Data reported in this study indicate the need of investigating partner of β-thalassemia carrier by complete sequencing analysis of β-globin gene and of providing an appropriate genetic counseling for couples at risk undergoing prenatal diagnosis.
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Affiliation(s)
- M Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Leto
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Calvaruso
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - R Di Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - D Renda
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Hemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
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Vinciguerra M, Passarello C, Leto F, Cassarà F, Cannata M, Maggio A, Giambona A. Co-inheritance of the rare β hemoglobin variants Hb Yaounde, Hb Görwihl and Hb City of Hope with other alterations in globin genes: impact in genetic counseling. Eur J Haematol 2014; 94:322-9. [DOI: 10.1111/ejh.12431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Margherita Vinciguerra
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Cristina Passarello
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Filippo Leto
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Filippo Cassarà
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Monica Cannata
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Aurelio Maggio
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Antonino Giambona
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
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Damiani G, Vinciguerra M, Jakil C, Cannata M, Cassarà F, Picciotto F, Schillaci G, Cigna V, Renda D, Volpes A, Sammartano F, Milone S, Allegra A, Passarello C, Leto F, Giambona A. Prenatal Diagnosis of Hemoglobinopathies: From Fetoscopy to Coelocentesis. Thalassemia Reports 2014. [DOI: 10.4081/thal.2014.2200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Prenatal diagnosis of hemoglobinopathies involves the study of fetal material from blood, amniocytes, trophoblast coelomatic cells and fetal DNA in maternal circulation. Its first application dates back to the 70s and it involves globin chain synthesis analysis on fetal blood. In the 1980s molecular analysis was introduced as well as amniocentesis and chorionic villi sampling under high-resolution ultrasound imaging. The application of direct sequencing and polymerase chain reactionbased methodologies improved the DNA analysis procedures and reduced the sampling age for invasive prenatal diagnosis from 18 to 16–11 weeks allowing fetal genotyping within the first trimester of pregnancy. In the last years, fetal material obtained at 7–8 weeks of gestation by coelocentesis and isolation of fetal cells has provided new platforms on which to develop diagnostic capabilities while non-invasive technologies using fetal DNA in maternal circulation are starting to develop.
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Damiani G, Vinciguerra M, Jakil C, Cannata M, Cassarà F, Picciotto F, Schillaci G, Cigna V, Renda D, Volpes A, Sammartano F, Milone S, Allegra A, Passarello C, Leto F, Giambona A. Prenatal diagnosis of hemoglobinopathies: from fetoscopy to coelocentesis. Thal Rep 2014. [DOI: 10.4081/thal.2014.s1.2200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Vinciguerra M, Passarello C, Leto F, Cassarà F, Cannata M, Maggio A, Giambona A. Identification of three new nucleotide substitutions in the β-globin gene: laboratoristic approach and impact on genetic counselling for beta-thalassaemia. Eur J Haematol 2014; 92:444-9. [PMID: 24401016 DOI: 10.1111/ejh.12267] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE Over the past two decades, a wide range of available methods for DNA analysis have allowed us to identify defects in globin genes associated with haemoglobin disorders and to correlate specific mutations with phenotypic expression. The purpose of this study was to evaluate the nature of three new nucleotide changes, mutation or single nucleotide polymorphism, found in the beta-globin gene, to conduct an appropriate genetic counselling. PATIENTS AND METHODS We report the molecular study performed in three probands and their families, sampling during the screening programme conducted at the Laboratory for Molecular Prenatal Diagnosis of Hemoglobinopathies at Villa Sofia-Cervello Hospital in Palermo, Italy. RESULTS This work allowed us to report three new nucleotide substitutions of the β-globin gene: a substitution of the nucleotide 16 in the CAP site area (HBB: c.-35 A>G), a substitution of the nucleotide 478 in the second intron (HBB: c.316-373) in association with β-haemoglobin variant Hb G Copenhagen (HBB:c.142G>A) and a substitution of the nucleotide 1656 within the 3' UTR (HBB: c.*+182 G>A) in association with the 1393-bp deletion (NG_000007.3:g.70060_71452del1393). CONCLUSION The present work emphasizes the importance of reporting the observed nucleotide changes to the Haemoglobin Variant Database, especially in the case of new or rare undefined mutations, to facilitate the determination of their phenotypic expression and the possible interactions with known molecular defects and to formulate an appropriate genetic counselling for couples at risk.
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Affiliation(s)
- Margherita Vinciguerra
- Department of Haematology for Rare Diseases of Blood and Blood-forming Organs, Regional Reference Laboratory for Screening and Prenatal Diagnosis of Haemoglobinopathies, Villa Sofia-Cervello Hospital, Palermo, Italy
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Cassarà F, Maggio A. Iron load. Thalassemia Reports 2013. [DOI: 10.4081/thal.2013.s1.e5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recent research addressed the main role of hepcidin in the regulation of iron metabolism. However, while this mechanism could be relevant in causing iron load in Thalassemia Intermedia and Sickle-Cell Anemia, its role in Thalassemia Major (TM) is marginal. This is mainly due to the high impact of transfusional requirement into the severe increase of body iron. Moreover, the damage of iron load may be worsened by infections, as HCV hepatitis, or liver and endocrinological damage. One of the most relevant associations was found between splenectomy and increase of risk for mortality due,probably, to more severe iron load. These issues suggest as morbidity and mortality of this group of patients they do not depend only by our ability in controlling heart damage but even in preventing or treating particular infections and complications. This finding is supported by the impairment of survival curves in patients with complications different from heart damage. However, because, during recent years different direct and indirect methods to detect iron overload in patients affected by secondary hemochromatosis have been implemented, our ability to maintain under control iron load is significantly improved. Anyway, the future in iron load management remains to be able to have an iron load map of our body for targeting chelation and other medical treatment according to the single organ damage.
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Vinciguerra M, Cannata M, Cassarà F, Lo Gioco P, Leto F, Passarello C, Giambona A. Role of Novel and Rare Nucleotide Substitutions of the β-Globin Gene. Thalassemia Reports 2012. [DOI: 10.4081/thal.2012.e4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Laboratory for Molecular Prenatal Diagnosis of Hemoglobinopathies at the Villa Sofia-Cervello Hospital in Palermo, Italy, carries out an intensive screening program aimed at identifying the healthy carriers of thalassemia and, consequently, the couples at risk of bearing an affected fetus. The diagnostic process is basically divided into two phases: (i) hematologic and hemoglobin data; (ii) molecular analysis of globin genes and, when possible, a genetic study of the family. Since 2003, we have been performing DNA sequence analysis on those cases in which classical molecular methods failed to give a complete diagnostic response, particularly in phenotypes with borderline values of HbA2 with mild or absent microcytosis. During ten years of screening activities (from 2003 to 2012), twenty-seven unknown or rare nucleotide changes of the β-globin gene have been identified; hematologic and hemoglobin data have been carefully evaluated and, wherever possible, we have conducted a family study to evaluate whether a phenotypic expression could be associated to these nucleotide changes. Because of the limited numbers of cases for each mutation, the significance of these nucleotide substitutions has still not been fully clarified, and this raises a number of questions that need to be answered when carrying out appropriate genetic counseling for couples presumed to be at risk.
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Renda MC, Vitrano A, Attanasio M, Fecarotta E, Piazza A, Giambona A, Fiorentino G, Renda D, Rigano P, Calvaruso G, Cassarà F, Maggio A. Nonsense-Mediated Decay Mechanism Is a Possible Modifying Factor of Clinical Outcome in Nonsense cd39 Beta Thalassemia Genotype. Thalassemia Reports 2012. [DOI: 10.4081/thal.2012.e2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Nonsense-mediated mRNA decay (NMD) is a surveillance system to prevent the synthesis of non-functional proteins. In β-thalassemia, NMD may have a role in clinical outcome. An example of premature translation stop codons appearing for the first time is the β-globin cd39 mutation; when homozygous, this results in a severe phenotype. The aim of this study was to determine whether the homozygous nonsense cd39 may have a milder phenotype in comparison with IVS1,nt110/cd39 genotype. Genotypes have been identified from a cohort of 568 patients affected by β-thalassemia. These genotypes were compared with those found in 577 affected fetuses detected among 2292 prenatal diagnoses. The nine most common genotypes, each with an incidence rate of 1.5% or over, and together accounting for 80% of genotype frequencies, underwent statistical analysis. Genotype prevalence was calculated within the overall group. Results are expressed as proportions with 95% confidence intervals; p ≤ 0.05 was considered statistically significant. A binomial distribution was assumed for each group; z-tests were used to compare genotype frequencies observed in the patient group with frequencies in the affected fetus group. In the absence of selecting factors, prevalence of these two genotypes was compared between a cohort of 568 β-thalassemia patients (PTS) and 577 affected fetuses (FOET) detected during the same period. IVS1,nt110/cd39 was significantly more prevalent in FOET than PTS (p < 0.0001), while there was no significant difference in prevalence of cd39/cd39 in FOET compared with PTS (p = 0.524). These results suggest a cd39 genotype NMD mechanism may be associated with improved clinical outcomes in thalassemia major.
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Restivo Pantalone G, Renda D, Valenza F, D'Amato F, Vitrano A, Cassarà F, Rigano P, Di Salvo V, Giangreco A, Bevacqua E, Maggio A. Hepatocellular carcinoma in patients with thalassaemia syndromes: clinical characteristics and outcome in a long term single centre experience. Br J Haematol 2010; 150:245-7. [PMID: 20433678 DOI: 10.1111/j.1365-2141.2010.08180.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Giambona A, Vinciguerra M, Cassarà F, Li Muli R, Leto F, Passarello C, Wajcman H, Maggio A. Hb Marineo [β70(E14)Ala→Val]: A Silent Hemoglobin Variant with a Mutation Within the Heme Pocket. Hemoglobin 2009; 30:139-48. [PMID: 16798637 DOI: 10.1080/03630260600642005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We report a new hemoglobin (Hb) variant, Hb Marineo [beta70(E14)Ala --> Val], found in three generations of a family from West Sicily. The mutation is due to a GCC --> GTC substitution at codon 70 of the beta-globin gene. To date, three mutations at codon 70 of the beta-globin gene have been described, presenting with hemolytic anemia. In our case, no anemia or other alteration of hematological indices were found. Cation exchange high performance liquid chromatography (HPLC) showed a peak in the P2 window (VARIANT I), while a peak was detected by VARIANT II HPLC in the P3 window. Reversed phase HPLC analysis showed an abnormal chain amounting to about 40% of the total beta chains.
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Affiliation(s)
- Antonino Giambona
- Azienda Ospedaliera Vincenzo Cervello, UO Ematologia II, Palermo, Italy.
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Maggio A, Capra M, Pepe A, Mancuso L, Cracolici E, Vitabile S, Rigano P, Cassarà F, Midiri M. A critical review of non invasive procedures for the evaluation of body iron burden in thalassemia major patients. Pediatr Endocrinol Rev 2008; 6 Suppl 1:193-203. [PMID: 19337178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
It is evident that different non invasive methodologies have been implemented for the detection of organ specific iron burden in patients with thalassemia major. Among these MR relaxometry has the potential to become the method of choice for non-invasive, safe and accurate assessment of organ-specific iron load, although further theoretical research, along with studies monitoring wider age groups of patients, is needed. Moreover, the possibility of detecting organ-specific iron burden is relevant for tailoring specific chelation treatment in different patients or in the same patient during different periods of life. In fact, while heart organ-specific effect has been suggested by MR relaxometry for some chelation treatments, it is possible to suppose that another single chelator or association of other chelators may show different organ-specific effects. For these reasons, the future of our clinical research will be to understand, mainly by MR relaxometry, whether it would be possible to set up a tailored organ-specific chelation treatment, according to this supposed difference in organ efficacy of the current chelation therapies.
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Affiliation(s)
- Aurelio Maggio
- Division of Haematology II with Thalassemia, Hospital V. Cervello, Via Trabucco n'180, and Radiology Institute, University of Palermo, Policlinico P. Giaccone, Palermo, Italy.
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