1
|
Rack KA, van den Berg E, Haferlach C, Beverloo HB, Costa D, Espinet B, Foot N, Jeffries S, Martin K, O'Connor S, Schoumans J, Talley P, Telford N, Stioui S, Zemanova Z, Hastings RJ. European recommendations and quality assurance for cytogenomic analysis of haematological neoplasms: reponse to the comments from the Francophone Group of Hematological Cytogenetics (GFCH). Leukemia 2020; 34:2262-2264. [PMID: 32042082 PMCID: PMC7387292 DOI: 10.1038/s41375-020-0736-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 11/28/2019] [Accepted: 01/29/2020] [Indexed: 01/30/2023]
Affiliation(s)
- K A Rack
- GenQA, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - E van den Berg
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C Haferlach
- MLL-Munich Leukemia Laboratory, Munich, Germany
| | - H B Beverloo
- Department of Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - D Costa
- Hematopathology Section, Hospital Clinic, Barcelona, Spain
| | - B Espinet
- Laboratori de Citogenètica Molecular, Servei de Patologia, Grup de Recerca, Translacional en Neoplàsies Hematològiques, Cancer Research Program, imim-Hospital del Mar, Barcelona, Spain
| | - N Foot
- Viapath Genetics Laboratories, Guys Hospital, London, UK
| | - S Jeffries
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - K Martin
- Department of Cytogenetics, Nottingham University Hospital, Nottingham, UK
| | - S O'Connor
- Haematological Malignancy Diagnostic Service, St James's University Hospital, Leeds, UK
| | - J Schoumans
- Oncogénomique laboratory, Hematology Department, Lausanne University Hospital, Vaudois, Switzerland
| | - P Talley
- Haematological Malignancy Diagnostic Service, St James's University Hospital, Leeds, UK
| | - N Telford
- Oncology Cytogenetics Service, The Christie NHS Foundation Trust, Manchester, UK
| | - S Stioui
- Laboratorio di Citogenetica e genetica moleculaire, Laboratorio Analisi, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Z Zemanova
- Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - R J Hastings
- GenQA, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK.
| |
Collapse
|
2
|
Rack KA, van den Berg E, Haferlach C, Beverloo HB, Costa D, Espinet B, Foot N, Jeffries S, Martin K, O'Connor S, Schoumans J, Talley P, Telford N, Stioui S, Zemanova Z, Hastings RJ. European recommendations and quality assurance for cytogenomic analysis of haematological neoplasms. Leukemia 2019; 33:1851-1867. [PMID: 30696948 PMCID: PMC6756035 DOI: 10.1038/s41375-019-0378-z] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 12/11/2018] [Accepted: 12/17/2018] [Indexed: 12/20/2022]
Abstract
Cytogenomic investigations of haematological neoplasms, including chromosome banding analysis, fluorescence in situ hybridisation (FISH) and microarray analyses have become increasingly important in the clinical management of patients with haematological neoplasms. The widespread implementation of these techniques in genetic diagnostics has highlighted the need for guidance on the essential criteria to follow when providing cytogenomic testing, regardless of choice of methodology. These recommendations provide an updated, practical and easily available document that will assist laboratories in the choice of testing and methodology enabling them to operate within acceptable standards and maintain a quality service.
Collapse
Affiliation(s)
- K A Rack
- GenQA, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - E van den Berg
- Department of Genetics University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C Haferlach
- MLL-Munich Leukemia Laboratory, Munich, Germany
| | - H B Beverloo
- Department of Clinical Genetics, Erasmus MC, University medical center, Rotterdam, The Netherlands
| | - D Costa
- Hematopathology Section, Hospital Clinic, Barcelona, Spain
| | - B Espinet
- Laboratori de Citogenètica Molecular, Servei de Patologia, Grup de Recerca,Translacional en Neoplàsies Hematològiques, Cancer Research Program, imim-Hospital del Mar, Barcelona, Spain
| | - N Foot
- Viapath Genetics laboratories, Guys Hospital, London, UK
| | - S Jeffries
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - K Martin
- Department of Cytogenetics, Nottingham University Hospital, Nottingham, UK
| | - S O'Connor
- Haematological Malignancy Diagnostic Service, St James's University Hospital, Leeds, UK
| | - J Schoumans
- Oncogénomique laboratory, Hematology department, Lausanne University Hospital, Vaudois, Switzerland
| | - P Talley
- Haematological Malignancy Diagnostic Service, St James's University Hospital, Leeds, UK
| | - N Telford
- Oncology Cytogenetics Service, The Christie NHS Foundation Trust, Manchester, UK
| | - S Stioui
- Laboratorio di Citogenetica e genetica moleculaire, Laboratorio Analisi, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Z Zemanova
- Prague Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - R J Hastings
- GenQA, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK.
| |
Collapse
|
3
|
Zachariadis V, Schoumans J, Ofverholm I, Barbany G, Halvardsson E, Forestier E, Johansson B, Nordenskjöld M, Nordgren A. Detecting dic(9;20)(p13.2;p11.2)-positive B-cell precursor acute lymphoblastic leukemia in a clinical setting using fluorescence in situ hybridization. Leukemia 2013; 28:196-8. [PMID: 23787394 DOI: 10.1038/leu.2013.189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- V Zachariadis
- 1] Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden [2] Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden [3] Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - J Schoumans
- Service de Génétique Médicale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - I Ofverholm
- 1] Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden [2] Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden [3] Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - G Barbany
- 1] Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden [2] Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden [3] Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - E Halvardsson
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - E Forestier
- Department of Clinical Sciences, Pediatrics, University of Umeå, Umeå, Sweden
| | - B Johansson
- Department of Clinical Genetics, University and Regional Laboratories, Skåne University Hospital, Lund University, Lund, Sweden
| | - M Nordenskjöld
- 1] Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden [2] Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden [3] Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - A Nordgren
- 1] Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden [2] Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden [3] Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
4
|
Makrythanasis P, van Bon BW, Steehouwer M, Rodríguez-Santiago B, Simpson M, Dias P, Anderlid BM, Arts P, Bhat M, Augello B, Biamino E, Bongers EMHF, del Campo M, Cordeiro I, Cueto-González AM, Cuscó I, Deshpande C, Frysira E, Izatt L, Flores R, Galán E, Gener B, Gilissen C, Granneman SM, Hoyer J, Yntema HG, Kets CM, Koolen DA, Marcelis CL, Medeira A, Micale L, Mohammed S, de Munnik SA, Nordgren A, Psoni S, Reardon W, Revencu N, Roscioli T, Ruiterkamp-Versteeg M, Santos HG, Schoumans J, Schuurs-Hoeijmakers JHM, Silengo MC, Toledo L, Vendrell T, van der Burgt I, van Lier B, Zweier C, Reymond A, Trembath RC, Perez-Jurado L, Dupont J, de Vries BBA, Brunner HG, Veltman JA, Merla G, Antonarakis SE, Hoischen A. MLL2mutation detection in 86 patients with Kabuki syndrome: a genotype-phenotype study. Clin Genet 2013; 84:539-45. [DOI: 10.1111/cge.12081] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 12/17/2012] [Accepted: 12/17/2012] [Indexed: 01/25/2023]
Affiliation(s)
- P Makrythanasis
- Departement of Genetic Medicine and Development; University of Geneva; Geneva Switzerland
| | - BW van Bon
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - M Steehouwer
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - B Rodríguez-Santiago
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
| | - M Simpson
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - P Dias
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - BM Anderlid
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine; Karolinska Institutet
- Department of Clinical Genetics; Karolinska University Hospital; Stockholm Sweden
| | - P Arts
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - M Bhat
- Centre for Human Genetics; Bangalore India
| | - B Augello
- Medical Genetics Unit; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo
| | - E Biamino
- Dipartimento di Scienze Pediatriche; Università di Torino; Torino Italy
| | - EMHF Bongers
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - M del Campo
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
- CIBER de enfermedades raras (CIBERER)
- Programa de Medicina Molecular y Genética; Hospital Vall d'Hebron
| | - I Cordeiro
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - AM Cueto-González
- Programa de Medicina Molecular y Genética; Hospital Vall d'Hebron
- Pediatric Service, Hospital Universitari Mútua de Terrassa; Terrassa (Barcelona) Spain
| | - I Cuscó
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
- CIBER de enfermedades raras (CIBERER)
| | - C Deshpande
- Clinical Genetics, Guy's Hospital; Guy's and St. Thomas' National Health Service (NHS) Foundation Trust; London UK
| | - E Frysira
- Laboratory of Medical Genetics, Medical School; University of Athens; Athens Greece
| | - L Izatt
- Servicio de Genética, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo; Bizkaia, Spain
| | - R Flores
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
- CIBER de enfermedades raras (CIBERER)
| | - E Galán
- Servicio de Genética, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo; Bizkaia, Spain
| | - B Gener
- Clinical Genetics Unit; Hospital de Cruces; Barakaldo Bizkaia Spain
| | - C Gilissen
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - SM Granneman
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - J Hoyer
- Institute of Human Genetics; Friedrich-Alexander-University Erlangen-Nuremberg; Erlangen Germany
| | - HG Yntema
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - CM Kets
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - DA Koolen
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - CL Marcelis
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - A Medeira
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - L Micale
- Department of Clinical Genetics; Karolinska University Hospital; Stockholm Sweden
| | - S Mohammed
- Clinical Genetics, Guy's Hospital; Guy's and St. Thomas' National Health Service (NHS) Foundation Trust; London UK
| | - SA de Munnik
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - A Nordgren
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine; Karolinska Institutet
- Department of Clinical Genetics; Karolinska University Hospital; Stockholm Sweden
| | - S Psoni
- Laboratory of Medical Genetics, Medical School; University of Athens; Athens Greece
| | - W Reardon
- National Centre for Medical Genetics; Our Lady's Hospital for Sick Children; Dublin 12 Ireland
| | - N Revencu
- Centre for Human Genetics, Cliniques Universitaires Saint-Luc; Université Catholique de Louvain; Brussels Belgium
| | - T Roscioli
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- School of Women's and Children's Health, Sydney Children's Hospital; University of New South Wales; Sydney Australia
| | - M Ruiterkamp-Versteeg
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - HG Santos
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - J Schoumans
- Department of Medical Genetics, Cancer Cytogenetic Unit; University Hospital of Lausanne; Lausanne Switzerland
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
| | - JHM Schuurs-Hoeijmakers
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - MC Silengo
- Dipartimento di Scienze Pediatriche; Università di Torino; Torino Italy
| | - L Toledo
- Hospital Materno Infantil; Unidad de Neurologia Infantil; Las Palmas de Gran Canaria Spain
| | - T Vendrell
- Programa de Medicina Molecular y Genética; Hospital Vall d'Hebron
| | - I van der Burgt
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - B van Lier
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - C Zweier
- Institute of Human Genetics; Friedrich-Alexander-University Erlangen-Nuremberg; Erlangen Germany
| | - A Reymond
- The Center for Integrative Genomics; University of Lausanne; Lausanne
| | - RC Trembath
- Division of Genetics and Molecular Medicine, Guy's Hospital; King's College London School of Medicine; London UK
| | - L Perez-Jurado
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
- CIBER de enfermedades raras (CIBERER)
| | - J Dupont
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - BBA de Vries
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - HG Brunner
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - JA Veltman
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - G Merla
- Medical Genetics Unit; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo
| | - SE Antonarakis
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- Service of Genetic Medicine; University Hospitals of Geneva; Geneva Switzerland
| | - A Hoischen
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| |
Collapse
|
5
|
Gijsbers ACJ, Schoumans J, Ruivenkamp CAL. Interpretation of array comparative genome hybridization data: a major challenge. Cytogenet Genome Res 2011; 135:222-7. [PMID: 22086107 DOI: 10.1159/000334066] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The advent and application of high-resolution array-based comparative genome hybridization (array CGH) has led to the detection of large numbers of copy number variants (CNVs) in patients with developmental delay and/or multiple congenital anomalies as well as in healthy individuals. The notion that CNVs are also abundantly present in the normal population challenges the interpretation of the clinical significance of detected CNVs in patients. In this review we will illustrate a general clinical workflow based on our own experience that can be used in routine diagnostics for the interpretation of CNVs.
Collapse
Affiliation(s)
- A C J Gijsbers
- Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | | | | |
Collapse
|
6
|
Wincent J, Bruno DL, van Bon BWM, Bremer A, Stewart H, Bongers EMHF, Ockeloen CW, Willemsen MH, Keays DDA, Baird G, Newbury DF, Kleefstra T, Marcelis C, Kini U, Stark Z, Savarirayan R, Sheffield LJ, Zuffardi O, Slater HR, de Vries BB, Knight SJL, Anderlid BM, Schoumans J. Sixteen New Cases Contributing to the Characterization of Patients with Distal 22q11.2 Microduplications. Mol Syndromol 2011; 1:246-254. [PMID: 22140377 DOI: 10.1159/000327982] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2011] [Indexed: 11/19/2022] Open
Abstract
The chromosome region 22q11.2 has long been recognized to be susceptible to genomic rearrangement. More recently, this genomic instability has been shown to extend distally (involving LCR22E-H) to the commonly deleted/duplicated region. To date, 21 index cases with 'distal' 22q11.2 duplications have been reported. We report on the clinical and molecular characterization of 16 individuals with distal 22q11.2 duplications identified by DNA microarray analysis. Two of the individuals have been partly described previously. The clinical phenotype varied among the patients in this study, although the majority displayed various degrees of developmental delay and speech disturbances. Other clinical features included behavioral problems, hypotonia, and dysmorphic facial features. Notably, none of the patients was diagnosed with a congenital heart defect. We found a high degree of inherited duplications. Additional copy number changes of unclear clinical significance were identified in 5 of our patients, and it is possible that these may contribute to the phenotypic expression in these patients as has been suggested recently in a 2-hit 'digenic' model for 16p12.1 deletions. The varied phenotypic expression and incomplete penetrance observed for distal 22q11.2 duplications makes it exceedingly difficult to ascribe pathogenicity for these duplications. Given the observed enrichment of the duplication in patient samples versus healthy controls, it is likely that distal 22q11.2 duplications represent a susceptibility/risk locus for speech and mild developmental delay.
Collapse
Affiliation(s)
- J Wincent
- Clinical Genetics Unit, Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Zachariadis V, Gauffin F, Kuchinskaya E, Heyman M, Schoumans J, Blennow E, Gustafsson B, Barbany G, Golovleva I, Ehrencrona H, Cavelier L, Palmqvist L, Lönnerholm G, Nordenskjöld M, Johansson B, Forestier E, Nordgren A. The frequency and prognostic impact of dic(9;20)(p13.2;q11.2) in childhood B-cell precursor acute lymphoblastic leukemia: results from the NOPHO ALL-2000 trial. Leukemia 2011; 25:622-8. [DOI: 10.1038/leu.2010.318] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
8
|
Wincent J, Anderlid BM, Lagerberg M, Nordenskjöld M, Schoumans J. High-resolution molecular karyotyping in patients with developmental delay and/or multiple congenital anomalies in a clinical setting. Clin Genet 2011; 79:147-57. [DOI: 10.1111/j.1399-0004.2010.01442.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
9
|
Bruno DL, Anderlid BM, Lindstrand A, van Ravenswaaij-Arts C, Ganesamoorthy D, Lundin J, Martin CL, Douglas J, Nowak C, Adam MP, Kooy RF, Van der Aa N, Reyniers E, Vandeweyer G, Stolte-Dijkstra I, Dijkhuizen T, Yeung A, Delatycki M, Borgstrom B, Thelin L, Cardoso C, van Bon B, Pfundt R, de Vries BBA, Wallin A, Amor DJ, James PA, Slater HR, Schoumans J. Further molecular and clinical delineation of co-locating 17p13.3 microdeletions and microduplications that show distinctive phenotypes. J Med Genet 2010; 47:299-311. [DOI: 10.1136/jmg.2009.069906] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
10
|
Lindstrand A, Schoumans J, Gustavsson P, Hanemaaijer N, Malmgren H, Blennow E. Improved structural characterization of chromosomal breakpoints using high resolution custom array-CGH. Clin Genet 2010; 77:552-62. [DOI: 10.1111/j.1399-0004.2009.01341.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
11
|
Lindstrand A, Malmgren H, Sahlén S, Schoumans J, Nordgren A, Ergander U, Holm E, Anderlid BM, Blennow E. Detailed molecular and clinical characterization of three patients with 21q deletions. Clin Genet 2009; 77:145-54. [PMID: 19863549 DOI: 10.1111/j.1399-0004.2009.01289.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We have investigated three patients with 21q deletions, two with developmental delay, dysmorphic features and internal organ malformations, and one with cognitive function within the normal range but with some deficits in gross and fine motor development. All aberrations were characterized by array-comparative genomic hybridization (array-CGH). In addition, extensive fluorescence in situ hybridization (FISH) mapping on metaphase chromosomes and mechanically stretched chromosomes was performed on patient 1 who had an extremely complex intrachromosomal rearrangement with 16 breakpoints, four deletions and four duplications. Patients 2 and 3 had interstitial deletions comprising 21q21.1-21q22.11 and 21q11.2-21q21.3, respectively. Partial deletions of 21q are rare and these patients display a highly variable phenotype depending on the size and position of the deletion. A review of the literature identified 38 cases with pure 21q deletions. Twenty-three of these had reliable mapping data. The combined information of present and previous cases suggests that the ITSN1 gene is involved in severe mental retardation in patients with 21q deletion. In addition, a critical region of 0.56 Mb containing four genes, KCNE1, DSCR1, CLIC6 and RUNX1, is associated with severe congenital heart defects, and deletions of the most proximal 15-17 Mb of 21q is associated with mild or no cognitive impairment, but may lead to problems with balance and motor function.
Collapse
Affiliation(s)
- A Lindstrand
- Department of Molecular Medicine and Surgery, Clinical Genetics Unit, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Lindstrand A, Malmgren H, Sahlén S, Xin H, Schoumans J, Blennow E. Molecular cytogenetic characterization of a constitutional, highly complex intrachromosomal rearrangement of chromosome 1, with 14 breakpoints and a 0.5 Mb submicroscopic deletion. Am J Med Genet A 2009; 146A:3217-22. [PMID: 19006217 DOI: 10.1002/ajmg.a.32570] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A Lindstrand
- Department of Molecular Medicine and Surgery, Clinical Genetics Unit, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | | | | | |
Collapse
|
13
|
Bruno DL, Ganesamoorthy D, Schoumans J, Bankier A, Coman D, Delatycki M, Gardner RJM, Hunter M, James PA, Kannu P, McGillivray G, Pachter N, Peters H, Rieubland C, Savarirayan R, Scheffer IE, Sheffield L, Tan T, White SM, Yeung A, Bowman Z, Ngo C, Choy KW, Cacheux V, Wong L, Amor DJ, Slater HR. Detection of cryptic pathogenic copy number variations and constitutional loss of heterozygosity using high resolution SNP microarray analysis in 117 patients referred for cytogenetic analysis and impact on clinical practice. J Med Genet 2008; 46:123-31. [PMID: 19015223 DOI: 10.1136/jmg.2008.062604] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Microarray genome analysis is realising its promise for improving detection of genetic abnormalities in individuals with mental retardation and congenital abnormality. Copy number variations (CNVs) are now readily detectable using a variety of platforms and a major challenge is the distinction of pathogenic from ubiquitous, benign polymorphic CNVs. The aim of this study was to investigate replacement of time consuming, locus specific testing for specific microdeletion and microduplication syndromes with microarray analysis, which theoretically should detect all known syndromes with CNV aetiologies as well as new ones. METHODS Genome wide copy number analysis was performed on 117 patients using Affymetrix 250K microarrays. RESULTS 434 CNVs (195 losses and 239 gains) were found, including 18 pathogenic CNVs and 9 identified as "potentially pathogenic". Almost all pathogenic CNVs were larger than 500 kb, significantly larger than the median size of all CNVs detected. Segmental regions of loss of heterozygosity larger than 5 Mb were found in 5 patients. CONCLUSIONS Genome microarray analysis has improved diagnostic success in this group of patients. Several examples of recently discovered "new syndromes" were found suggesting they are more common than previously suspected and collectively are likely to be a major cause of mental retardation. The findings have several implications for clinical practice. The study revealed the potential to make genetic diagnoses that were not evident in the clinical presentation, with implications for pretest counselling and the consent process. The importance of contributing novel CNVs to high quality databases for genotype-phenotype analysis and review of guidelines for selection of individuals for microarray analysis is emphasised.
Collapse
Affiliation(s)
- D L Bruno
- Cytogenetics Laboratory, Victorian Clinical Genetics Services/Pathology, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Wincent J, Holmberg E, Strömland K, Soller M, Mirzaei L, Djureinovic T, Robinson K, Anderlid B, Schoumans J. CHD7 mutation spectrum in 28 Swedish patients diagnosed with CHARGE syndrome. Clin Genet 2008; 74:31-8. [PMID: 18445044 DOI: 10.1111/j.1399-0004.2008.01014.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CHARGE syndrome is a disorder characterized by Coloboma, Heart defect, Atresia choanae, Retarded growth and/or development, Genital hypoplasia and Ear anomalies. Heterozygous mutations in the chromodomain helicase DNA-binding protein 7 (CHD7) gene have been identified in about 60% of individuals diagnosed with CHARGE syndrome. We performed a CHD7 mutation screening by direct exon sequencing in 28 index patients (26 sporadic cases, 1 familial case consisting of a brother and sister and 1 case consisting of monozygotic twins) diagnosed with CHARGE syndrome in order to determine the mutations in a cohort of Swedish CHARGE syndrome patients. The patients without a detectable CHD7 mutation, or with a missense mutation, were further investigated by multiplex ligation-dependent probe amplification (MLPA) in order to search for intragenic deletions or duplications. Thirteen novel mutations and five previously reported mutations were detected. The mutations were scattered throughout the gene and included nonsense, frameshift and missense mutations as well as intragenic deletions. In conclusion, CHD7 mutations were detected in a large proportion (64%) of cases diagnosed with CHARGE syndrome. Screening for intragenic deletions with MLPA is recommended in cases where mutations are not found by sequencing. In addition, a CDH7 mutation was found in an individual without temporal bone malformation.
Collapse
Affiliation(s)
- J Wincent
- Department of Molecular Medicine and Surgery, CMM L8:02, Karolinska University Hospital Solna, Stockholm, Sweden.
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
|
16
|
Maas NMC, Van Buggenhout G, Hannes F, Thienpont B, Sanlaville D, Kok K, Midro A, Andrieux J, Anderlid BM, Schoumans J, Hordijk R, Devriendt K, Fryns JP, Vermeesch JR. Genotype-phenotype correlation in 21 patients with Wolf-Hirschhorn syndrome using high resolution array comparative genome hybridisation (CGH). J Med Genet 2007; 45:71-80. [PMID: 17873117 DOI: 10.1136/jmg.2007.052910] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [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: 11/03/2022]
Abstract
BACKGROUND The Wolf-Hirschhorn syndrome (WHS) is usually caused by terminal deletions of the short arm of chromosome 4 and is phenotypically defined by growth and mental retardation, seizures, and specific craniofacial manifestations. Large variation is observed in phenotypic expression of these features. In order to compare the phenotype with the genotype, we localised the breakpoints of the 4 pter aberrations using a chromosome 4 specific tiling BAC/PAC array. METHODS In total, DNA from 21 patients was analysed, of which 8 had a cytogenetic visible and 13 a submicroscopic deletion. RESULTS AND CONCLUSION In addition to classical terminal deletions sized between 1.9 and 30 Mb, we observed the smallest terminal deletion (1.4 Mb) ever reported in a patient with mild WHS stigmata. In addition, we identified and mapped interstitial deletions in four patients. This study positions the genes causing microcephaly, intrauterine and postnatal growth retardation between 0.3 and 1.4 Mb and further refines the regions causing congenital heart disease, cleft lip and/or palate, oligodontia, and hypospadias.
Collapse
Affiliation(s)
- N M C Maas
- Center for Human Genetics, University Hospital, Catholic University of Leuven, Leuven, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Kuchinskaya E, Nordgren A, Heyman M, Schoumans J, Corcoran M, Staaf J, Borg A, Söderhäll S, Grandér D, Nordenskjöld M, Blennow E. Tiling-resolution array-CGH reveals the pattern of DNA copy number alterations in acute lymphoblastic leukemia with 21q amplification: the result of telomere dysfunction and breakage/fusion/breakage cycles? Leukemia 2007; 21:1327-30. [PMID: 17315016 DOI: 10.1038/sj.leu.2404628] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
18
|
Schoumans J, Ruivenkamp C, Holmberg E, Kyllerman M, Anderlid BM, Nordenskjöld M. Detection of chromosomal imbalances in children with idiopathic mental retardation by array based comparative genomic hybridisation (array-CGH). J Med Genet 2006; 42:699-705. [PMID: 16141005 PMCID: PMC1736138 DOI: 10.1136/jmg.2004.029637] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.6] [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: 11/03/2022]
Abstract
Chromosomal aberrations are a common cause of multiple anomaly syndromes that include growth and developmental delay and dysmorphism. Novel high resolution, whole genome technologies, such as array based comparative genomic hybridisation (array-CGH), improve the detection rate of submicroscopic chromosomal abnormalities allowing re-investigation of cases where conventional cytogenetic techniques, Spectral karyotyping (SKY), and FISH failed to detect abnormalities. We performed a high resolution genome-wide screening for submicroscopic chromosomal rearrangements using array-CGH on 41 children with idiopathic mental retardation (MR) and dysmorphic features. The commercially available microarray from Spectral Genomics contained 2600 BAC clones spaced at approximately 1 Mb intervals across the genome. Standard chromosome analysis (>450 bands per haploid genome) revealed no chromosomal rearrangements. In addition, multi-subtelomeric FISH screening in 30 cases and SKY in 11 patients did not detect any abnormality. Using array-CGH we detected chromosomal imbalances in four patients (9.8%) ranging in size from 2 to 14 Mb. Large scale copy number variations were frequently observed. Array-CGH has become an important tool for the detection of chromosome aberrations and has the potential to identify genes involved in developmental delay and dysmorphism. Moreover, the detection of genomic imbalances of clinical significance will increase knowledge of the human genome by performing genotype-phenotype correlation.
Collapse
Affiliation(s)
- J Schoumans
- Department of Molecular Medicine, Karolinska Hospital, CMM L8:02, SE-17176 Stockholm, Sweden.
| | | | | | | | | | | |
Collapse
|
19
|
Gustavsson P, Schoumans J, Staaf J, Jönsson G, Carlsson F, Kristoffersson U, Borg A, Nordenskjöld M, Dahl N. Hemizygosity for chromosome 2q14.2-q22.1 spanning the GLI2 and PROC genes associated with growth hormone deficiency, polydactyly, deep vein thrombosis and urogenital abnormalities. Clin Genet 2006; 69:441-3. [PMID: 16650085 DOI: 10.1111/j.1399-0004.2006.00601.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Karpova MB, Schoumans J, Ernberg I, Henter JI, Nordenskjöld M, Fadeel B. Raji revisited: cytogenetics of the original Burkitt's lymphoma cell line. Leukemia 2005; 19:159-61. [PMID: 15457187 DOI: 10.1038/sj.leu.2403534] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
21
|
Schoumans J, Anderlid BM, Blennow E, Teh BT, Nordenskjöld M. The performance of CGH array for the detection of cryptic constitutional chromosome imbalances. J Med Genet 2004; 41:198-202. [PMID: 14985382 PMCID: PMC1735686 DOI: 10.1136/jmg.2003.013920] [Citation(s) in RCA: 22] [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: 11/04/2022]
|
22
|
Akervall J, Guo X, Qian M, Schoumans J, Yuhas J, Carey T, Leeser B, Bradford C, Tennvall J, Teh B. 106 Genetic and expression profiles of squamous cell carcinoma of the head and neck correlate with cisplatin sensitivity and resistance in cell lines and patients. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90139-x] [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: 12/01/2022] Open
|
23
|
Grigelioniene G, Schoumans J, Neumeyer L, Ivarsson A, Eklöf O, Enkvist O, Tordai P, Fosdal I, Myhre AG, Westphal O, Nilsson NO, Elfving M, Ellis I, Anderlid BM, Fransson I, Tapia-Paez I, Nordenskjöld M, Hagenäs L, Dumanski JP. Analysis of short stature homeobox-containing gene ( SHOX) and auxological phenotype in dyschondrosteosis and isolated Madelung deformity. Hum Genet 2001; 109:551-8. [PMID: 11735031 DOI: 10.1007/s00439-001-0609-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2001] [Accepted: 08/30/2001] [Indexed: 10/28/2022]
Abstract
Dyschondrosteosis (DCO; also called Léri-Weill syndrome) is a skeletal dysplasia characterised by disproportionate short stature because of mesomelic shortening of the limbs. Madelung deformity is a feature of DCO that is distinctive, variable in expressivity and frequently observed. Mutations of the SHOX (short stature homeobox-containing) gene have been previously described as causative in DCO. Isolated Madelung deformity (IMD) without the clinical characteristics of DCO has also been described in sporadic and a few familial cases but the genetic defect underlying IMD is unknown. In this study, we have examined 28 probands with DCO and seven probands with IMD for mutations in the SHOX gene by using polymorphic CA-repeat analysis, fluorescence in situ hybridisation (FISH), Southern blotting, direct sequencing and fibre-FISH analyses. This was combined with auxological examination of the probands and their family members. Evaluation of the auxological data showed a wide intra- and interfamilial phenotype variability in DCO. Out of 28 DCO probands, 22 (79%) were shown to have mutations in the SHOX gene. Sixteen unrelated DCO families had SHOX gene deletions. Four novel DCO-associated mutations were found in different families. In two additional DCO families, the previously described nonsense mutation (Arg195Stop) was detected. We conclude that mutations in the SHOX gene are the major factor in the pathogenesis of DCO. In a female proband with severe IMD and her unaffected sister, we detected an intrachromosomal duplication of the SHOX gene.
Collapse
Affiliation(s)
- G Grigelioniene
- Paediatric Endocrinology Unit, Karolinska Hospital, Stockholm, Sweden.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Nordgren A, Schoumans J, Söderhäll S, Nordenskjöld M, Blennow E. Interphase fluorescence in situ hybridization and spectral karyotyping reveals hidden genetic aberrations in children with acute lymphoblastic leukaemia and a normal banded karyotype. Br J Haematol 2001; 114:786-93. [PMID: 11564064 DOI: 10.1046/j.1365-2141.2001.03008.x] [Citation(s) in RCA: 15] [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: 11/20/2022]
Abstract
Twenty-two cases of childhood acute lymphoblastic leukaemia (ALL) with normal G- or Q-banded karyotypes were studied by interphase fluorescence in situ hybridization (FISH) and spectral karyotyping. Probes detecting MLL, BCR/ABL and TEL/AML1 rearrangements were used for the interphase studies, along with centromere-specific probes from chromosomes 17 and X. In 10 patients (45%), previously undetected aberrations were demonstrable. Specific gene rearrangements and structural changes were found in six cases and numerical changes in five. Five of these aberrations have previously been reported to have an impact on prognosis. Three cases were massively hyperdiploid and, in one, the prognostically important BCR/ABL fusion was detected. In addition, a near-haploid karyotype with 27 chromosomes was found in one patient and TEL/AML1 rearrangements were detected in two cases. This study indicates that about half of childhood ALL cases with apparently normal karyotypes harbour genetic aberrations that may be detected using interphase FISH and spectral karyotyping.
Collapse
Affiliation(s)
- A Nordgren
- Department of Molecular Medicine, L8-02 Karolinska Hospital, SE-171 76 Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
25
|
Anderlid BM, Sahlén S, Schoumans J, Holmberg E, Ahsgren I, Mortier G, Speleman F, Blennow E. Detailed characterization of 12 supernumerary ring chromosomes using micro-FISH and search for uniparental disomy. Am J Med Genet 2001; 99:223-33. [PMID: 11241494 DOI: 10.1002/1096-8628(2001)9999:9999<::aid-ajmg1146>3.0.co;2-w] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Twelve patients with varying degrees of mosaicism for a supernumerary ring chromosome were studied. The ring chromosomes were characterized using microdissection in combination with degenerate nucleotide-primed polymerase chain reaction (PCR) and reverse painting (micro-FISH). This method made it possible to determine the chromosomal origin of the ring chromosomes in detail, and thus to compare the phenotypes of similar cases. Eleven of the marker chromosomes were derived from the most proximal part of 1p, 3p, 3q, 5p, 7q, 8p, 8q, 9p, 10p and 20p. One marker chromosome had a complex origin, including the proximal and the most distal part of 20q. Eight of the families were also investigated for uniparental disomy (UPD) using microsatellite analysis. One case with maternal UPD 9 was found in a child with a ring chromosome derived from chromosome 9, r(9)(p10p12).
Collapse
Affiliation(s)
- B M Anderlid
- Department of Molecular Medicine, Clinical Genetics Unit, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | | | | | | | | | |
Collapse
|