1
|
Krizsán S, Péterffy B, Egyed B, Nagy T, Sebestyén E, Hegyi LL, Jakab Z, Erdélyi DJ, Müller J, Péter G, Csanádi K, Kállay K, Kriván G, Barna G, Bedics G, Haltrich I, Ottóffy G, Csernus K, Vojcek Á, Tiszlavicz LG, Gábor KM, Kelemen Á, Hauser P, Gaál Z, Szegedi I, Ujfalusi A, Kajtár B, Kiss C, Matolcsy A, Tímár B, Kovács G, Alpár D, Bödör C. Next-Generation Sequencing-Based Genomic Profiling of Children with Acute Myeloid Leukemia. J Mol Diagn 2023; 25:555-568. [PMID: 37088137 PMCID: PMC10435843 DOI: 10.1016/j.jmoldx.2023.04.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/11/2023] [Accepted: 04/05/2023] [Indexed: 04/25/2023] Open
Abstract
Pediatric acute myeloid leukemia (AML) represents a major cause of childhood leukemic mortality, with only a limited number of studies investigating the molecular landscape of the disease. Here, we present an integrative analysis of cytogenetic and molecular profiles of 75 patients with pediatric AML from a multicentric, real-world patient cohort treated according to AML Berlin-Frankfurt-Münster protocols. Targeted next-generation sequencing of 54 genes revealed 17 genes that were recurrently mutated in >5% of patients. Considerable differences were observed in the mutational profiles compared with previous studies, as BCORL1, CUX1, KDM6A, PHF6, and STAG2 mutations were detected at a higher frequency than previously reported, whereas KIT, NRAS, and KRAS were less frequently mutated. Our study identified novel recurrent mutations at diagnosis in the BCORL1 gene in 9% of the patients. Tumor suppressor gene (PHF6, TP53, and WT1) mutations were found to be associated with induction failure and shorter event-free survival, suggesting important roles of these alterations in resistance to therapy and disease progression. Comparison of the mutational landscape at diagnosis and relapse revealed an enrichment of mutations in tumor suppressor genes (16.2% versus 44.4%) and transcription factors (35.1% versus 55.6%) at relapse. Our findings shed further light on the heterogeneity of pediatric AML and identify previously unappreciated alterations that may lead to improved molecular characterization and risk stratification of pediatric AML.
Collapse
Affiliation(s)
- Szilvia Krizsán
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Borbála Péterffy
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Bálint Egyed
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Tibor Nagy
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Endre Sebestyén
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Lajos László Hegyi
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Jakab
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Dániel J Erdélyi
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Judit Müller
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - György Péter
- Hemato-Oncology Unit, Heim Pal Children's Hospital, Budapest, Hungary
| | - Krisztina Csanádi
- Hemato-Oncology Unit, Heim Pal Children's Hospital, Budapest, Hungary
| | - Krisztián Kállay
- Division of Pediatric Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Gergely Kriván
- Division of Pediatric Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Gábor Barna
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Gábor Bedics
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Irén Haltrich
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Gábor Ottóffy
- Department of Pediatrics, University of Pécs Clinical Centre, Pécs, Hungary
| | - Katalin Csernus
- Department of Pediatrics, University of Pécs Clinical Centre, Pécs, Hungary
| | - Ágnes Vojcek
- Department of Pediatrics, University of Pécs Clinical Centre, Pécs, Hungary
| | - Lilla Györgyi Tiszlavicz
- Department of Pediatrics and Pediatric Health Care Center, University of Szeged, Szeged, Hungary
| | - Krisztina Mita Gábor
- Department of Pediatrics and Pediatric Health Care Center, University of Szeged, Szeged, Hungary
| | - Ágnes Kelemen
- Hemato-Oncology and Stem Cell Transplantation Unit, Velkey László Child's Health Center, Borsod-Abaúj-Zemplén County Central Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Péter Hauser
- Hemato-Oncology and Stem Cell Transplantation Unit, Velkey László Child's Health Center, Borsod-Abaúj-Zemplén County Central Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Zsuzsanna Gaál
- Department of Pediatric Hematology and Oncology, Institute of Pediatrics, University of Debrecen, Debrecen, Hungary
| | - István Szegedi
- Department of Pediatric Hematology and Oncology, Institute of Pediatrics, University of Debrecen, Debrecen, Hungary
| | - Anikó Ujfalusi
- Department of Laboratory Medicine, University of Debrecen, Debrecen, Hungary
| | - Béla Kajtár
- Department of Pathology, University of Pécs Clinical Centre, Pécs, Hungary
| | - Csongor Kiss
- Hemato-Oncology and Stem Cell Transplantation Unit, Velkey László Child's Health Center, Borsod-Abaúj-Zemplén County Central Hospital and University Teaching Hospital, Miskolc, Hungary
| | - András Matolcsy
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Botond Tímár
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Gábor Kovács
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Donát Alpár
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
2
|
Bedics G, Egyed B, Kotmayer L, Benard-Slagter A, de Groot K, Bekő A, Hegyi LL, Bátai B, Krizsán S, Kriván G, Erdélyi DJ, Müller J, Haltrich I, Kajtár B, Pajor L, Vojcek Á, Ottóffy G, Ujfalusi A, Szegedi I, Tiszlavicz LG, Bartyik K, Csanádi K, Péter G, Simon R, Hauser P, Kelemen Á, Sebestyén E, Jakab Z, Matolcsy A, Kiss C, Kovács G, Savola S, Bödör C, Alpár D. PersonALL: a genetic scoring guide for personalized risk assessment in pediatric B-cell precursor acute lymphoblastic leukemia. Br J Cancer 2023; 129:455-465. [PMID: 37340093 PMCID: PMC10403542 DOI: 10.1038/s41416-023-02309-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/08/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Recurrent genetic lesions provide basis for risk assessment in pediatric acute lymphoblastic leukemia (ALL). However, current prognostic classifiers rely on a limited number of predefined sets of alterations. METHODS Disease-relevant copy number aberrations (CNAs) were screened genome-wide in 260 children with B-cell precursor ALL. Results were integrated with cytogenetic data to improve risk assessment. RESULTS CNAs were detected in 93.8% (n = 244) of the patients. First, cytogenetic profiles were combined with IKZF1 status (IKZF1normal, IKZF1del and IKZF1plus) and three prognostic subgroups were distinguished with significantly different 5-year event-free survival (EFS) rates, IKAROS-low (n = 215): 86.3%, IKAROS-medium (n = 27): 57.4% and IKAROS-high (n = 18): 37.5%. Second, contribution of genetic aberrations to the clinical outcome was assessed and an aberration-specific score was assigned to each prognostically relevant alteration. By aggregating the scores of aberrations emerging in individual patients, personalized cumulative values were calculated and used for defining four prognostic subgroups with distinct clinical outcomes. Two favorable subgroups included 60% of patients (n = 157) with a 5-year EFS of 96.3% (excellent risk, n = 105) and 87.2% (good risk, n = 52), respectively; while 40% of patients (n = 103) showed high (n = 74) or ultra-poor (n = 29) risk profile (5-year EFS: 67.4% and 39.0%, respectively). CONCLUSIONS PersonALL, our conceptually novel prognostic classifier considers all combinations of co-segregating genetic alterations, providing a highly personalized patient stratification.
Collapse
Affiliation(s)
- Gábor Bedics
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Bálint Egyed
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Lili Kotmayer
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | | | | | - Anna Bekő
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Lajos László Hegyi
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Bence Bátai
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Szilvia Krizsán
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Gergely Kriván
- Central Hospital of Southern Pest - National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Dániel J Erdélyi
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Judit Müller
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Irén Haltrich
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Béla Kajtár
- Department of Pathology, University of Pécs Medical School, Pécs, Hungary
| | - László Pajor
- Department of Pathology, University of Pécs Medical School, Pécs, Hungary
| | - Ágnes Vojcek
- Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary
| | - Gábor Ottóffy
- Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary
| | - Anikó Ujfalusi
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - István Szegedi
- Division of Pediatric Hematology-Oncology, Institute of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Lilla Györgyi Tiszlavicz
- Department of Paediatrics and Paediatric Health Care Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Katalin Bartyik
- Department of Paediatrics and Paediatric Health Care Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Krisztina Csanádi
- Hemato-Oncology Unit, Heim Pál Children's Hospital, Budapest, Hungary
| | - György Péter
- Hemato-Oncology Unit, Heim Pál Children's Hospital, Budapest, Hungary
| | - Réka Simon
- Hemato-Oncology and Stem Cell Transplantation Unit, Velkey László Children's Health Center, Miskolc, Hungary
| | - Péter Hauser
- Hemato-Oncology and Stem Cell Transplantation Unit, Velkey László Children's Health Center, Miskolc, Hungary
| | - Ágnes Kelemen
- Hemato-Oncology and Stem Cell Transplantation Unit, Velkey László Children's Health Center, Miskolc, Hungary
| | - Endre Sebestyén
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Jakab
- Hungarian Childhood Cancer Registry, Hungarian Pediatric Oncology Network, Budapest, Hungary
| | - András Matolcsy
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
- Department of Laboratory Medicine, Karolinska Institute, Solna, Sweden
| | - Csongor Kiss
- Division of Pediatric Hematology-Oncology, Institute of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Kovács
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | | | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Donát Alpár
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
3
|
Lengyel A, Pinti É, Pikó H, Kristóf Á, Abonyi T, Némethi Z, Fekete G, Haltrich I. Clinical evaluation of rare copy number variations identified by chromosomal microarray in a Hungarian neurodevelopmental disorder patient cohort. Mol Cytogenet 2022; 15:47. [PMID: 36320065 PMCID: PMC9623912 DOI: 10.1186/s13039-022-00623-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/22/2022] [Accepted: 09/30/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Neurodevelopmental disorders are genetically heterogeneous pediatric conditions. The first tier diagnostic method for uncovering copy number variations (CNVs), one of the most common genetic etiologies in affected individuals, is chromosomal microarray (CMA). However, this methodology is not yet a routine molecular cytogenetic test in many parts of the world, including Hungary. Here we report clinical and genetic data of the first, relatively large Hungarian cohort of patients whose genetic testing included CMA. METHODS Clinical data were retrospectively collected for 78 children who were analyzed using various CMA platforms. Phenotypes of patients with disease-causing variants were compared to patients with negative results using the chi squared/Fisher exact tests. RESULTS A total of 30 pathogenic CNVs were identified in 29 patients (37.2%). Postnatal growth delay (p = 0.05564), pectus excavatum (p = 0.07484), brain imaging abnormalities (p = 0.07848), global developmental delay (p = 0.08070) and macrocephaly (p = 0.08919) were more likely to be associated with disease-causing CNVs. CONCLUSION Our results allow phenotypic expansion of 14q11.2 microdeletions encompassing SUPT16H and CHD8 genes. Variants of unknown significance (n = 24) were found in 17 patients. We provide detailed phenotypic and genetic data of these individuals to facilitate future classification efforts, and spotlight two patients with potentially pathogenic alterations. Our results contribute to unraveling the diagnostic value of rare CNVs.
Collapse
Affiliation(s)
- Anna Lengyel
- grid.11804.3c0000 0001 0942 9821II. Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Éva Pinti
- grid.11804.3c0000 0001 0942 9821II. Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Henriett Pikó
- grid.11804.3c0000 0001 0942 9821Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Árvai Kristóf
- grid.11804.3c0000 0001 0942 9821Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Tünde Abonyi
- grid.11804.3c0000 0001 0942 9821II. Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Zaránd Némethi
- grid.11804.3c0000 0001 0942 9821II. Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - György Fekete
- grid.11804.3c0000 0001 0942 9821II. Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Irén Haltrich
- grid.11804.3c0000 0001 0942 9821II. Department of Pediatrics, Semmelweis University, Budapest, Hungary
| |
Collapse
|
4
|
Szűcs Z, Pinti É, Haltrich I, Szén OP, Nagy T, Barta E, Méhes G, Bidiga L, Török O, Ujfalusi A, Koczok K, Balogh I. An Ultra-Rare Manifestation of an X-Linked Recessive Disorder: Duchenne Muscular Dystrophy in a Female Patient. Int J Mol Sci 2022; 23:ijms232113076. [PMID: 36361862 PMCID: PMC9655586 DOI: 10.3390/ijms232113076] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/30/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is the most common inherited muscle dystrophy. Patients are characterized by muscle weakness, gross motor delay, and elevated serum creatinine kinase (CK) levels. The disease is caused by mutations in the DMD gene located on the X chromosome. Due to the X-linked recessive inheritance pattern, DMD most commonly affects males, who are generally diagnosed between the age of 3–5 years. Here we present an ultra-rare manifestation of DMD in a female patient. Cytogenetic examination showed that she has a t(X;10)(p21.1;p12.1) translocation, which turned out to affect the DMD gene with one of the breakpoints located in exon 54 (detected by genome sequencing). The X-inactivation test revealed skewed X-inactivation (ratio 99:1). Muscle histology and dystrophin immunohistochemistry showed severe dystrophic changes and highly reduced dystrophin expression, respectively. These results, in accordance with the clinical picture and a highly elevated serum CK, led to the diagnosis of DMD. In conclusion, although in very rare cases, DMD can manifest in female patients as well. In this case, a balanced X-autosome reciprocal translocation disrupts the DMD gene and skewed X-inactivation leads to the manifestation of the DMD phenotype.
Collapse
Affiliation(s)
- Zsuzsanna Szűcs
- Division of Clinical Genetics, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, 4032 Debrecen, Hungary
| | - Éva Pinti
- 2nd Department of Pediatrics, Semmelweis University, 1094 Budapest, Hungary
| | - Irén Haltrich
- 2nd Department of Pediatrics, Semmelweis University, 1094 Budapest, Hungary
| | - Orsolya Pálné Szén
- Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, 4032 Debrecen, Hungary
| | - Tibor Nagy
- Bioinformatics and Functional Genome Analysis Research Group, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Endre Barta
- Bioinformatics and Functional Genome Analysis Research Group, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Department of Genetics and Genomics, Institute of Genetics and Biotechnology, Hungarian University of Agriculture and Life Sciences, 2100 Gödöllő, Hungary
| | - Gábor Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - László Bidiga
- Department of Pathology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Olga Török
- Medical and Health Science Centre, Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Anikó Ujfalusi
- Division of Clinical Genetics, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Katalin Koczok
- Division of Clinical Genetics, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Correspondence: (K.K.); (I.B.)
| | - István Balogh
- Division of Clinical Genetics, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, 4032 Debrecen, Hungary
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Correspondence: (K.K.); (I.B.)
| |
Collapse
|
5
|
Szumutku F, Kádár K, Kovács ÁF, Lengyel A, Pinti É, Némethi Z, Abonyi T, Csáky-Szunyogh M, Fekete G, Haltrich I. A 22q11.2-microdeletiós szindróma klinikai jellemzői. Orv Hetil 2022; 163:21-30. [DOI: 10.1556/650.2022.32299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/22/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló.
Bevezetés: A sokszínű tünetspektrummal jellemezhető
DiGeorge-szindróma leggyakoribb oka a 22q11.2-microdeletio; incidenciája
1/4000–6000. Célkitűzés: A DiGeorge-szindrómára gyanús hazai
betegcsoport 22q11.2-microdeletióval társult tüneteinek/panaszainak részletes
feltérképezése, a betegség incidenciájának becslése és egy magyarországi
22q11.2-microdeletiós szindróma regiszter létrehozása. Módszer:
2005 és 2019 között a Semmelweis Egyetem II. Gyermekgyógyászati Klinikájára
DiGeorge-szindróma gyanújával beutalt és a Veleszületett Rendellenességek
Országos Nyilvántartása által regisztrált DiGeorge-szindrómás betegek adatait
dolgoztuk fel. A fenotípusjegyeket a Humán Fenotípus Ontológia kódrendszer
alapján határoztuk meg. Eredmények: A vizsgálatba 114, igazolt
DiGeorge-szindrómás és 113, FISH-vizsgálattal microdeletiót nem hordozó, de
klinikailag a DiGeorge-szindróma tüneteit mutató beteget vontunk be. A diagnózis
felállításakor a betegek átlagéletkora 5,88 (± 9,66 SD) év volt, eddig a betegek
54,9%-a legalább egy szívműtéten átesett. A betegek leggyakoribb tünetei a
kamrai sövényhiány, a mélyen ülő fülek, a gótikus szájpad, a motoros fejlődési
elmaradás és a visszatérő fertőzések voltak. Megbeszélés: A
DiGeorge-szindróma becsült incidenciája hazánkban 1/12 500, közöttük magas a
többszörösen veszélyeztetett újszülöttek és a műtéti korrekcióra szorulók
aránya. A diagnózis hazánkban 2–3 évvel korábban történik a nemzetközi átlaghoz
viszonyítva. Következtetés: A létrehozott regiszterünk alapján
Magyarországon a kórkép aluldiagnosztizált. Minden conotruncalis szívfejlődési
rendellenesség vagy jelentős kamrai sövényhiány esetén citogenetikai vizsgálat
javasolt a DiGeorge-szindróma felmerülő gyanúja miatt. Negatív lelet esetén az
atípusos töréspontú microdeletiók azonosítására komparatív genomiális
hibridizáció vagy multiplex ligatiofüggő próbaamplifikációs vizsgálat javasolt.
A betegek számára multidiszciplináris ellátás szükséges, III-as progresszivitási
szintű újszülött intenzív részlegen, gyermekkardiológus és klinikai genetikus
részvételével. Orv Hetil. 2022; 163(1): 21–30.
Summary.
Introduction: The 22q11.2 microdeletion syndrome is the most
common cause of DiGeorge syndrome, showing a wide phenotypic spectrum and has an
estimated incidence of 1/4000–6000 livebirths. Objective:
Detailed characterization of the clinical signs/symptoms associated with 22q11.2
deletion, estimation of the national incidence via establishing
a Hungarian register. Method: Retrospective data between 2005
and 2019 from the 2nd Department of Paediatrics, Semmelweis
University and from national database of congenital anomalies were obtained.
Phenotypic abnormalities were described using the Human Phenotype Ontology
nomenclature. Results: A cohort of 114 DiGeorge patients and
113 patients negative for FISH testing were included. The mean age of patients
at diagnosis was 5.88 (± 9.66 SD) years and 54.9% of patients had at least one
heart surgery until diagnosis. The main identified symptoms were ventricular
septal defect, low-set ears, recurrent infections, high narrow palate and motor
development delay. Discussion: The estimated incidence of
DiGeorge syndrome in Hungary is 1/12 500 births, the frequency of infants at
high risk and in need for surgery is high. Diagnosis is established 2–3 years
earlier as compared to the international average. Conclusion:
Based on the established Hungarian register, the incidence is lower compared to
international data. In the case of conotruncal heart anomaly and ventricular
septal defects, cytogenetic testing is recommended for the increased probability
of DiGeorge syndrome. For second-tier testing, comparative genome hybridization
or multiplex ligation-dependent probe amplification are recommended to identify
atypical microdeletions. Newborns with DiGeorge syndrome require special care in
perinatal intensive centers including pediatric cardiology and genetic
counseling. Orv Hetil. 2022; 163(1): 21–30.
Collapse
Affiliation(s)
- Fanni Szumutku
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest, Pf. 2, 1428
| | - Krisztina Kádár
- Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika Budapest
| | - Árpád Ferenc Kovács
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest, Pf. 2, 1428
| | - Anna Lengyel
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest, Pf. 2, 1428
| | - Éva Pinti
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest, Pf. 2, 1428
| | - Zaránd Némethi
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest, Pf. 2, 1428
| | - Tünde Abonyi
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest, Pf. 2, 1428
| | | | - György Fekete
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest, Pf. 2, 1428
| | - Irén Haltrich
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest, Pf. 2, 1428
| |
Collapse
|
6
|
Lengyel A, Pinti É, Eggermann T, Fekete G, Haltrich I. Deletion of 16q22.2q23.3 in a Boy with a Phenotype Reminiscent of Silver-Russell Syndrome. Mol Syndromol 2021; 12:300-304. [PMID: 34602957 DOI: 10.1159/000515941] [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: 01/21/2021] [Accepted: 03/16/2021] [Indexed: 11/19/2022] Open
Abstract
A 15-month-old boy presented with growth and global developmental delay, feeding difficulties, sleep disturbance and several minor anomalies, including a large anterior fontanel, relative macrocephaly, and a triangular face. Clinical suspicion prompted genetic investigations for Silver-Russell syndrome and related disorders. SNP array analysis led to the diagnosis of an approximately 10-Mb large deletion of the long arm in chromosome 16q22.2q23.3. Interstitial deletions of 16q show a wide variability of related features; however, considering the differences in size and location of the deletions in the known patients, the phenotypic overlap is surprising. Here, we report a novel microdeletion, compare the proband with data from scientific literature and international databases, and discuss possible diagnostic implications.
Collapse
Affiliation(s)
- Anna Lengyel
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Éva Pinti
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Thomas Eggermann
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - György Fekete
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Irén Haltrich
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| |
Collapse
|
7
|
Lengyel A, Pinti ÉV, Nebral K, Pikó H, Ujfalusi A, Haas OA, Fekete G, Haltrich I. Chromosome 2q14.3 microdeletion encompassing CNTNAP5 gene in a patient carrying a complex chromosomal rearrangement. J Genet 2021; 100:66. [PMID: 34553698] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
We report a patient with loss of chromosome region 2q14.3 encompassing exon 1 of the gene CNTNAP5. The deletion occurred in association with a de novo complex chromosomal rearrangement, characterized by routine G-banding, fluorescence in situ hybridization and microarray analysis. The presented patient's phenotype is dominated by severe early childhood weight gain, severe speech delay and behavioural problems. To our knowledge, a few similar patients have been reported previously. CNTNAP5 is a member of the neurexin gene family and is associated with autism spectrum disorder and potentially other behavioural and neurodevelopmental disorders. Recent data point to its possible role in obesity and/or metabolism. The phenotype of the herein presented pediatric patient corroborates CNTNAP5's pathogenic role in human disease.
Collapse
Affiliation(s)
- Anna Lengyel
- Department of Pediatrics II, Semmelweis University, Budapest 1094, Hungary
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Hathy E, Szabó E, Vincze K, Haltrich I, Kiss E, Varga N, Erdei Z, Várady G, Homolya L, Apáti Á, Réthelyi JM. Generation of multiple iPSC clones from a male schizophrenia patient carrying de novo mutations in genes KHSRP, LRRC7, and KIR2DL1, and his parents. Stem Cell Res 2020; 51:102140. [PMID: 33503521 DOI: 10.1016/j.scr.2020.102140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/01/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022] Open
Abstract
Here we describe the generation of induced pluripotent stem cell lines from each member - male proband, mother, father - of a schizophrenia case-parent trio that participated in an exome sequencing study, and 3 de novo mutations were identified in the proband. Peripheral blood mononuclear cells were obtained from all three individuals and reprogrammed using Sendai virus particles carrying the Yamanaka transgenes. These 3 iPSC lines (iPSC-SZ-HU-MO 1, iPSC-SZ-HU-FA 1, and iPSC-SZ-HU-PROB 1) represent a resource for examining the functional significance of the identified de novo mutations in the molecular pathophysiology of schizophrenia.
Collapse
Affiliation(s)
- Edit Hathy
- Molecular Psychiatry Research Group, National Brain Research Program (NAP), Hungarian Academy of Sciences and Semmelweis University, Hungary; Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Eszter Szabó
- Institute of Enzymology, Research Center for Natural Sciences, Eötvös Loránd Research Network, Hungary
| | - Katalin Vincze
- Molecular Psychiatry Research Group, National Brain Research Program (NAP), Hungarian Academy of Sciences and Semmelweis University, Hungary; Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Irén Haltrich
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Eszter Kiss
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Nóra Varga
- Institute of Enzymology, Research Center for Natural Sciences, Eötvös Loránd Research Network, Hungary
| | - Zsuzsa Erdei
- Institute of Enzymology, Research Center for Natural Sciences, Eötvös Loránd Research Network, Hungary
| | - György Várady
- Institute of Enzymology, Research Center for Natural Sciences, Eötvös Loránd Research Network, Hungary
| | - László Homolya
- Institute of Enzymology, Research Center for Natural Sciences, Eötvös Loránd Research Network, Hungary
| | - Ágota Apáti
- Institute of Enzymology, Research Center for Natural Sciences, Eötvös Loránd Research Network, Hungary
| | - János M Réthelyi
- Molecular Psychiatry Research Group, National Brain Research Program (NAP), Hungarian Academy of Sciences and Semmelweis University, Hungary; Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
9
|
Lengyel A, Pinti É, Pikó H, Jávorszky E, David D, Tihanyi M, Gönczi É, Kiss E, Tóth Z, Tory K, Fekete G, Haltrich I. Clinical and genetic findings in Hungarian pediatric patients carrying chromosome 16p copy number variants and a review of the literature. Eur J Med Genet 2020; 63:104027. [PMID: 32758661 DOI: 10.1016/j.ejmg.2020.104027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 07/10/2020] [Accepted: 07/25/2020] [Indexed: 11/27/2022]
Abstract
The short arm of chromosome 16 (16p) is enriched for segmental duplications, making it susceptible to recurrent, reciprocal rearrangements implicated in the etiology of several phenotypes, including intellectual disability, speech disorders, developmental coordination disorder, autism spectrum disorders, attention deficit hyperactivity disorders, obesity and congenital skeletal disorders. In our clinical study 73 patients were analyzed by chromosomal microarray, and results were confirmed by fluorescence in situ hybridization or polymerase chain reaction. All patients underwent detailed clinical evaluation, with special emphasis on behavioral symptoms. 16p rearrangements were identified in 10 individuals. We found six pathogenic deletions and duplications of the recurrent regions within 16p11.2: one patient had a deletion of the distal 16p11.2 region associated with obesity, while four individuals had duplications, and one patient a deletion of the proximal 16p11.2 region. The other four patients carried 16p variations as second-site genomic alterations, acting as possible modifying genetic factors. We present the phenotypic and genotypic results of our patients and discuss our findings in relation to the available literature.
Collapse
Affiliation(s)
- Anna Lengyel
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary.
| | - Éva Pinti
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Henriett Pikó
- I Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Eszter Jávorszky
- I Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Dezső David
- Department of Human Genetics, National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
| | - Mariann Tihanyi
- Department of Genetics, Zala County Hospital, Zalaegerszeg, Hungary
| | - Éva Gönczi
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Eszter Kiss
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Zsuzsa Tóth
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Kálmán Tory
- I Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - György Fekete
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Irén Haltrich
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| |
Collapse
|
10
|
Hamadeh L, Enshaei A, Schwab C, Alonso CN, Attarbaschi A, Barbany G, den Boer ML, Boer JM, Braun M, Dalla Pozza L, Elitzur S, Emerenciano M, Fechina L, Felice MS, Fronkova E, Haltrich I, Heyman MM, Horibe K, Imamura T, Jeison M, Kovács G, Kuiper RP, Mlynarski W, Nebral K, Ivanov Öfverholm I, Pastorczak A, Pieters R, Piko H, Pombo-de-Oliveira MS, Rubio P, Strehl S, Stary J, Sutton R, Trka J, Tsaur G, Venn N, Vora A, Yano M, Harrison CJ, Moorman AV. Validation of the United Kingdom copy-number alteration classifier in 3239 children with B-cell precursor ALL. Blood Adv 2019; 3:148-157. [PMID: 30651283 PMCID: PMC6341196 DOI: 10.1182/bloodadvances.2018025718] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022] Open
Abstract
Genetic abnormalities provide vital diagnostic and prognostic information in pediatric acute lymphoblastic leukemia (ALL) and are increasingly used to assign patients to risk groups. We recently proposed a novel classifier based on the copy-number alteration (CNA) profile of the 8 most commonly deleted genes in B-cell precursor ALL. This classifier defined 3 CNA subgroups in consecutive UK trials and was able to discriminate patients with intermediate-risk cytogenetics. In this study, we sought to validate the United Kingdom ALL (UKALL)-CNA classifier and reevaluate the interaction with cytogenetic risk groups using individual patient data from 3239 cases collected from 12 groups within the International BFM Study Group. The classifier was validated and defined 3 risk groups with distinct event-free survival (EFS) rates: good (88%), intermediate (76%), and poor (68%) (P < .001). There was no evidence of heterogeneity, even within trials that used minimal residual disease to guide therapy. By integrating CNA and cytogenetic data, we replicated our original key observation that patients with intermediate-risk cytogenetics can be stratified into 2 prognostic subgroups. Group A had an EFS rate of 86% (similar to patients with good-risk cytogenetics), while group B patients had a significantly inferior rate (73%, P < .001). Finally, we revised the overall genetic classification by defining 4 risk groups with distinct EFS rates: very good (91%), good (81%), intermediate (73%), and poor (54%), P < .001. In conclusion, the UKALL-CNA classifier is a robust prognostic tool that can be deployed in different trial settings and used to refine established cytogenetic risk groups.
Collapse
Affiliation(s)
- Lina Hamadeh
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle, United Kingdom
| | - Amir Enshaei
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle, United Kingdom
| | - Claire Schwab
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle, United Kingdom
| | - Cristina N Alonso
- Hematology-Oncology Department, Hospital de Pediatría "Prof. Dr. J. P. Garrahan," Buenos Aires, Argentina
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Gisela Barbany
- Department of Molecular Medicine and Surgery, Clinical Genetics Section, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Judith M Boer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Marcin Braun
- Department of Pathology, Medical University of Lodz, Lodz, Poland
| | - Luciano Dalla Pozza
- Cancer Center for Children, Sydney Childrens Hospital Network, Westmead, NSW, Australia
| | - Sarah Elitzur
- Pediatric Hematology Oncology, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mariana Emerenciano
- Division of Clinical Research, Research Centre, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Larisa Fechina
- Regional Children's Hospital 1, Ekaterinburg, Russia
- Research Institute of Medical Cell Technologies, Ekaterinburg, Russia
| | - Maria Sara Felice
- Hematology-Oncology Department, Hospital de Pediatría "Prof. Dr. J. P. Garrahan," Buenos Aires, Argentina
| | - Eva Fronkova
- Childhood Leukaemia Investigation, Prague, Czech Republic
- Department of Paediatric Haematology/Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Irén Haltrich
- 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Mats M Heyman
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Marta Jeison
- Cancer Cytogenetic Laboratory, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Gábor Kovács
- 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Roland P Kuiper
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Wojciech Mlynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Karin Nebral
- Children's Cancer Research Institute, St. Anna Kinderkrebsforschung, Vienna, Austria
| | - Ingegerd Ivanov Öfverholm
- Department of Molecular Medicine and Surgery, Clinical Genetics Section, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agata Pastorczak
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Rob Pieters
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Dutch Childhood Oncology Group, Utrecht, The Netherlands
| | - Henriett Piko
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Maria S Pombo-de-Oliveira
- Pediatric Haematology-Oncology Program, Research Centre, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Patricia Rubio
- Hematology-Oncology Department, Hospital de Pediatría "Prof. Dr. J. P. Garrahan," Buenos Aires, Argentina
| | - Sabine Strehl
- Children's Cancer Research Institute, St. Anna Kinderkrebsforschung, Vienna, Austria
| | - Jan Stary
- Department of Paediatric Haematology/Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Rosemary Sutton
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW, Australia; and
| | - Jan Trka
- Childhood Leukaemia Investigation, Prague, Czech Republic
- Department of Paediatric Haematology/Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Grigory Tsaur
- Regional Children's Hospital 1, Ekaterinburg, Russia
- Research Institute of Medical Cell Technologies, Ekaterinburg, Russia
| | - Nicola Venn
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW, Australia; and
| | - Ajay Vora
- Department of Haematology, Great Ormond Street Hospital, London, United Kingdom
| | - Mio Yano
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Christine J Harrison
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle, United Kingdom
| | - Anthony V Moorman
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle, United Kingdom
| |
Collapse
|
11
|
Lengyel A, Kosik A, Pinti É, Lódi C, Tory K, Fekete G, Haltrich I. [Trisomy 9p and clinical heterogeneity: case report of an unusual presentation]. Orv Hetil 2018; 159:1994-2000. [PMID: 30474384 DOI: 10.1556/650.2018.31223] [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: 11/19/2022]
Abstract
Whole or partial trisomy of the short arm of chromosome 9 (9p) is considered to be one of the more frequent chromosome abnormalities compatible with life. The duplication may affect various organs, however the most common symptoms are certain specific facial dysmorphisms and abnormalities of the fingers, toes and nails. A one month old boy presented with failure to thrive, jaundice, ventricular septal defect (VSD) and dysmorphic face. He displayed symptoms of heart failure. The cardiologic examination revealed a significant VSD, hypoplasia of the aortic arch, pulmonary hypertension, decompensated circulatory failure and moderate left ventricle dysfunction. Routine cytogenetic analysis revealed a supernumerary marker chromosome. Fluorescence in situ hybridization (FISH) identified this as the short arm of chromosome 9. The child's karyotype was determined as 47,XY,+der(9)dup(9)(p10p24)dn. Due to his worsening condition and the high risk of the operation, it was decided to forego the procedure. After a short palliative care the child passed away. The child's clinical presentation and the uncharacteristic severity of his condition show that chromosome abnormalities involving duplicated genetic material are extremely heterogeneous. Thus treatment of each child should be individualized and may also involve difficult ethical considerations. Orv Hetil. 2018; 159(47): 1994-2000.
Collapse
Affiliation(s)
- Anna Lengyel
- II. Gyermekgyógyászati Klinika, Genetikai Részleg, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Pf. 2., 1428
| | - Anna Kosik
- I. Gyermekgyógyászati Klinika, Intenzív Terápiás Osztály, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Éva Pinti
- II. Gyermekgyógyászati Klinika, Genetikai Részleg, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Pf. 2., 1428
| | - Csaba Lódi
- I. Gyermekgyógyászati Klinika, Intenzív Terápiás Osztály, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Kálmán Tory
- I. Gyermekgyógyászati Klinika, MTA-SE Lendület Nephrogenetikai Kutatócsoport, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - György Fekete
- II. Gyermekgyógyászati Klinika, Genetikai Részleg, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Pf. 2., 1428
| | - Irén Haltrich
- II. Gyermekgyógyászati Klinika, Genetikai Részleg, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Pf. 2., 1428
| |
Collapse
|
12
|
Pinti É, Lengyel A, Sallai Á, Fekete G, Haltrich I. [Examination of sex chromosome abnormalities in childhood]. Orv Hetil 2018; 159:1121-1128. [PMID: 29961370 DOI: 10.1556/650.2018.31081] [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: 11/19/2022]
Abstract
INTRODUCTION Early diagnosis of sex chromosome abnormalities is important because of prevention, family planning and optimal therapy. AIM Investigation of the relationship between phenotype, age at time of diagnosis and therapeutic options in sex chromosome aberrations. METHOD Processing data of 51 children with sex chromosome abnormalities who were diagnosed between 2009 and 2014 and examined at the 2nd. Department of Pediatrics, Semmelweis University, by the methods of anamnesis, family tree analysis, physical examination, karyotype analysis and fluorescent in situ hybridisation. RESULTS 41% of the patients were diagnosed with Turner-, 18% with Klinefelter-, 10% with double-Y-, 6% with triple- and poly-X-syndrome, 19% with other gonadal dysgenesis and 6% with other abnormality. The average age at diagnosis: Turner- and Klinefelter-syndrome 10 years, other gonadal dysgenesis 9 years, 46,XX,t(X;10) 17 years, other abnormalities 1-2 years. CONCLUSIONS Numerical aberrations of the sex chromosomes are more common than structural aberrations. Klinefelter-, triple- and poly-X-syndromes are underdiagnosed in childhood. Early diagnosis of Turner-syndrome and other gonadal dysgenesis is necessary to optimise therapy and prevent associated diseases. This can be achieved by modern prenatal diagnostic methods and targeted activity of family pediatricians. Orv Hetil. 2018; 159(27): 1121-1128.
Collapse
Affiliation(s)
- Éva Pinti
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - Anna Lengyel
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - Ágnes Sallai
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - György Fekete
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - Irén Haltrich
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| |
Collapse
|
13
|
Berecz T, Molnar A, Haltrich I, Homolya L, Harding S, Rethelyi J, Merkely B, Foldes G, Apati A. P70Cardiomyocytes derived from induced pluripotent stem cells of patient with DiGeorge syndrome show slower beating frequency and higher irregularity. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.034] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Berecz
- Semmelweis University Heart Center, Budapest, Hungary
| | - A Molnar
- Semmelweis University Heart Center, Budapest, Hungary
| | - I Haltrich
- Semmelweis University, Budapest, Hungary
| | - L Homolya
- Hungarian Academy of Sciences, Budapest, Hungary
| | - S Harding
- Imperial College London, London, United Kingdom
| | - J Rethelyi
- Semmelweis University, Budapest, Hungary
| | - B Merkely
- Semmelweis University Heart Center, Budapest, Hungary
| | - G Foldes
- Semmelweis University Heart Center, Budapest, Hungary
| | - A Apati
- Hungarian Academy of Sciences, Budapest, Hungary
| |
Collapse
|
14
|
Mohácsik P, Erdélyi F, Baranyi M, Botz B, Szabó G, Tóth M, Haltrich I, Helyes Z, Sperlágh B, Tóth Z, Sinkó R, Lechan RM, Bianco AC, Fekete C, Gereben B. A Transgenic Mouse Model for Detection of Tissue-Specific Thyroid Hormone Action. Endocrinology 2018; 159:1159-1171. [PMID: 29253128 PMCID: PMC6283413 DOI: 10.1210/en.2017-00582] [Citation(s) in RCA: 10] [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] [Received: 06/23/2017] [Accepted: 12/08/2017] [Indexed: 01/03/2023]
Abstract
Thyroid hormone (TH) is present in the systemic circulation and thus should affect all cells similarly in the body. However, tissues have a complex machinery that allows tissue-specific optimization of local TH action that calls for the assessment of TH action in a tissue-specific manner. Here, we report the creation of a TH action indicator (THAI) mouse model to study tissue-specific TH action. The model uses a firefly luciferase reporter readout in the context of an intact transcriptional apparatus and all elements of TH metabolism and transport and signaling. The THAI mouse allows the assessment of the changes of TH signaling in tissue samples or in live animals using bioluminescence, both in hypothyroidism and hyperthyroidism. Beyond pharmacologically manipulated TH levels, the THAI mouse is sufficiently sensitive to detect deiodinase-mediated changes of TH action in the interscapular brown adipose tissue (BAT) that preserves thermal homeostasis during cold stress. The model revealed that in contrast to the cold-induced changes of TH action in the BAT, the TH action in this tissue, at room temperature, is independent of noradrenergic signaling. Our data demonstrate that the THAI mouse can also be used to test TH receptor isoform-specific TH action. Thus, THAI mouse constitutes a unique model to study tissue-specific TH action within a physiological/pathophysiological context and test the performance of thyromimetics. In conclusion, THAI mouse provides an in vivo model to assess a high degree of tissue specificity of TH signaling, allowing alteration of tissue function in health and disease, independently of changes in circulating levels of TH.
Collapse
Affiliation(s)
- Petra Mohácsik
- Department of Endocrine Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
- János Szentágothai PhD School of Neurosciences, Semmelweis University, Budapest, Hungary
| | - Ferenc Erdélyi
- Medical Gene Technology Unit, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - Mária Baranyi
- Laboratory of Molecular Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - Bálint Botz
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Centre for Neuroscience, Pécs, Hungary
- Molecular Pharmacology Research Team, János Szentágothai Research Centre, Pécs, Hungary
| | - Gábor Szabó
- Medical Gene Technology Unit, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - Mónika Tóth
- Department of Endocrine Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - Irén Haltrich
- Second Department of Pediatrics, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Centre for Neuroscience, Pécs, Hungary
- Molecular Pharmacology Research Team, János Szentágothai Research Centre, Pécs, Hungary
- Hungarian Academy of Sciences–University of Pécs, Hungarian Brain Research Program, Chronic Pain Research Group, University of Pécs Medical School, Pécs, Hungary
| | - Beáta Sperlágh
- Laboratory of Molecular Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - Zsuzsa Tóth
- Second Department of Pediatrics, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Richárd Sinkó
- Department of Endocrine Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
- János Szentágothai PhD School of Neurosciences, Semmelweis University, Budapest, Hungary
| | - Ronald M Lechan
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tupper Research Institute, Tufts Medical Center, Boston, Massachusetts
- Department of Neuroscience, Tufts University School of Medicine, Boston, Massachusetts
| | - Antonio C Bianco
- Division of Endocrinology and Metabolism, Rush University Medical Center, Chicago, Illinois
| | - Csaba Fekete
- Department of Endocrine Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tupper Research Institute, Tufts Medical Center, Boston, Massachusetts
- Correspondence: Csaba Fekete, MD, PhD, or Balázs Gereben, DVM, PhD, Department of Endocrine Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, 43 Szigony Street, Budapest, Hungary H-1083. E-mail: ; or
| | - Balázs Gereben
- Department of Endocrine Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| |
Collapse
|
15
|
Ács OD, Péterfia B, Hollósi P, Haltrich I, Sallai Á, Luczay A, Buiting K, Horsthemke B, Török D, Szabó A, Fekete G. [Rapid first-tier genetic diagnosis in patients with Prader-Willi syndrome]. Orv Hetil 2018; 159:64-69. [PMID: 29307221 DOI: 10.1556/650.2018.30918] [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: 11/19/2022]
Abstract
INTRODUCTION According to the international literature, DNA methylation analysis of the promoter region of SNRPN locus is the most efficient way to start genetic investigation in patients with suspected Prader-Willi syndrome. AIM Our aim was to develop a simple, reliable first-tier diagnosis to confirm Prader-Willi syndrome, therefore to compare our self-designed simple, cost-efficient high-resolution melting analysis and the most commonly used methylation-specific multiplex ligation-dependent probe amplification to confirm Prader-Willi syndrome. METHOD We studied 17 clinically suspected Prader-Willi syndrome children and their DNA samples. With self-designed primers, bisulfite-sensitive polymerase chain reaction, high-resolution melting analysis and, as a control, methylation-specific multiplex ligation-dependent probe amplification were performed. RESULTS Prader-Willi syndrome was genetically confirmed in 6 out of 17 clinically suspected Prader-Willi syndrome patients. The results of high-resolution melting analysis and methylation-specific multiplex ligation-dependent probe amplification were equivalent in each case. CONCLUSION Using our self-designed primers and altered bisulfite-specific PCR conditions, high-resolution melting analysis appears to be a simple, fast, reliable and effective method for primarily proving or excluding clinically suspected Prade-Willi syndrome cases. Orv Hetil. 2018; 159(2): 64-69.
Collapse
Affiliation(s)
- Orsolya Dóra Ács
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - Bálint Péterfia
- I. Patológiai és Kísérleti Rákkutató Intézet, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Péter Hollósi
- I. Patológiai és Kísérleti Rákkutató Intézet, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.,Daganatprogresszió Kutatócsoport, Magyar Tudományos Akadémia Budapest
| | - Irén Haltrich
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - Ágnes Sallai
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - Andrea Luczay
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - Karin Buiting
- Institut für Humangenetik, Universität Duisburg-Essen Essen, Germany
| | | | - Dóra Török
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - András Szabó
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| | - György Fekete
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Tűzoltó u. 7-9., 1094
| |
Collapse
|
16
|
Abstract
Abstract: Williams syndrome is a rare genetic disorder, that occurs equally in all ethnic groups and both sexes. The diagnosis might be missed during childhood in mild cases. However, establishing the diagnosis is important, not only to find the cause of intellectual disability but to look for cardiovascular, endocrine, psychiatry, urology and other conditions, which can occur at any age in the patients’ lifetime. This case report presents the story of 47-year-old woman, who was admitted with haematemesis. During her stay on the ward, in the light of the distinctive facial features, mental retardation, and social behaviour patterns, the possibility of Williams syndrome emerged. Later, the diagnosis was confirmed by genetic analysis. This female is the oldest living patient with Williams syndrome in Hungary. Orv Hetil. 2017; 158(47): 1883–1888.
Collapse
Affiliation(s)
| | - György Fekete
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Irén Haltrich
- II. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Miklós Tóth
- II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088
| | - Péter Reismann
- II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088
| |
Collapse
|
17
|
Haltrich I, Pikó H, Pamjav H, Somogyi A, Völgyi A, David D, Beke A, Garamvölgyi Z, Kiss E, Karcagi V, Fekete G. Complex X chromosome rearrangement associated with multiorgan autoimmunity. Mol Cytogenet 2015; 8:51. [PMID: 26191082 PMCID: PMC4506572 DOI: 10.1186/s13039-015-0152-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/23/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Turner syndrome, a congenital condition that affects 1/2,500 births, results from absence or structural alteration of the second sex chromosome. Turner syndrome is usually associated with short stature, gonadal dysgenesis and variable dysmorphic features. The classical 45,X karyotype accounts approximately for half of all patients, the remainder exhibit mosaicism or structural abnormalities of the X chromosome. However, complex intra-X chromosomal rearrangements involving more than three breakpoints are extremely rare. RESULTS We present a unique case of a novel complex X chromosome rearrangement in a young female patient presenting successively a wide range of autoimmune diseases including insulin dependent diabetes mellitus, Hashimoto's thyroiditis, celiac disease, anaemia perniciosa, possible inner ear disease and severe hair loss. For the genetic evaluation, conventional cytogenetic analysis and FISH with different X specific probes were initially performed. The complexity of these results and the variety of autoimmune problems of the patient prompted us to identify the exact composition and breakpoints of the rearranged X as well as methylation status of the X chromosomes. The high resolution array-CGH (assembly GRCh37/hg19) detected single copy for the whole chromosome X short arm. Two different sized segments of Xq arm were present in three copies: one large size of 80,3 Mb from Xq11.1 to Xq27.3 region and another smaller (11,1 Mb) from Xq27.3 to Xq28 region. An 1,6 Mb Xq27.3 region of the long arm was present in two copies. Southern blot analysis identified a skewed X inactivation with ≈ 70:30 % ratios of methylated/unmethylated fragments. The G-band and FISH patterns of the rearranged X suggested the aspect of a restructured i(Xq) chromosome which was shattered and fortuitously repaired. The X-STR genotype analysis of the family detected that the patient inherited intact maternal X chromosome and a rearranged paternal X chromosome. The multiple Xq breakages and fusions as well as inverted duplication would have been expected to cause a severe Turner phenotype. However, the patient lacks many of the classic somatic features of Turner syndrome, instead she presented multiorgan autoimmune diseases. CONCLUSIONS The clinical data of the presented patient suggest that fragmentation of the i(Xq) chromosome elevates the risk of autoimmune diseases.
Collapse
Affiliation(s)
- Irén Haltrich
- 2nd Department of Pediatrics, Semmelweis University, Tűzoltó utca 7-9, 1094 Budapest, Hungary
| | - Henriett Pikó
- Department of Molecular Genetics and Diagnostics, National Center of Public Health, Budapest, Hungary
| | - Horolma Pamjav
- DNA Laboratory, Institute of Forensic Medicine, Network of Forensic Science Institutes, Budapest, Hungary
| | - Anikó Somogyi
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Antónia Völgyi
- DNA Laboratory, Institute of Forensic Medicine, Network of Forensic Science Institutes, Budapest, Hungary
| | - Dezső David
- Department of Human Genetics, Organization National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Artúr Beke
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Zoltán Garamvölgyi
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Eszter Kiss
- 2nd Department of Pediatrics, Semmelweis University, Tűzoltó utca 7-9, 1094 Budapest, Hungary
| | - Veronika Karcagi
- Department of Molecular Genetics and Diagnostics, National Center of Public Health, Budapest, Hungary
| | - György Fekete
- 2nd Department of Pediatrics, Semmelweis University, Tűzoltó utca 7-9, 1094 Budapest, Hungary
| |
Collapse
|
18
|
Haltrich I, Pikó H, Kiss E, Tóth Z, Karcagi V, Fekete G. A de novo atypical ring sSMC(22) characterized by array CGH in a boy with cat-eye syndrome. Mol Cytogenet 2014; 7:37. [PMID: 24959203 PMCID: PMC4067088 DOI: 10.1186/1755-8166-7-37] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 05/21/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Microduplications 22q11 have been characterized as a genomic duplication syndrome mediated by nonallelic homologous recombination between region-specific low-copy repeats. Here we report on a 19 years old boy with intellectual disability having an unexpected structurally complex ring small supernumerary marker chromosome (sSMC) originated from a larger trisomy and a smaller tetrasomy of proximal 22q11 harboring additional copies of cat eye syndrome critical regions genes. RESULTS PRINCIPAL CLINICAL FEATURES WERE: anorectal and urogenital malformations, total anomalous pulmonary venous return with secundum ASD, hearing defect, preauricular pits, seizure and eczema. The proband also presented some rare or so far not reported clinical findings such as hyperinsulinaemia, severe immunodeficiency and grave cognitive deficits. Chromosome analysis revealed a mosaic karyotype with the presence of a small ring-like marker in 60% of cells. Array CGH detected approximately an 1,2 Mb single and a 0,2 Mb double copy gain of the proximal long arm of chromosome 22. The 1,3 Mb intervening region of chromosome 22 from centromere to the breakpoints showed no copy alteration. The karyotype of the patient was defined as 47,XY,+mar[60]/46,XY[40].ish idic r(22)(q11.1.q11.21) × 4.arr 22q11(17,435, 645-18,656,678) × 3,(17,598,642-17,799,783) × 4 dn. CONCLUSIONS The present report is the first one with a detailed description of clinical presentation in a patient carrying an atypical size ring sSMC (22) analyzed by array CGH. The specialty of the finding is emphasized by the fact that although the patient had a mosaic sSMC and the amplified region was smaller than in typical cat eye syndrome cases, the clinical presentation was severe.
Collapse
Affiliation(s)
- Irén Haltrich
- 2nd Department of Paediatrics, Semmelweis University, Tűzoltó utca 7-9, Budapest 1094, Hungary
| | - Henriett Pikó
- Department of Molecular Genetics and Diagnostics, National Institute of Environmental Health, Budapest, Hungary
| | - Eszter Kiss
- 2nd Department of Paediatrics, Semmelweis University, Tűzoltó utca 7-9, Budapest 1094, Hungary
| | - Zsuzsa Tóth
- 2nd Department of Paediatrics, Semmelweis University, Tűzoltó utca 7-9, Budapest 1094, Hungary
| | - Veronika Karcagi
- Department of Molecular Genetics and Diagnostics, National Institute of Environmental Health, Budapest, Hungary
| | - György Fekete
- 2nd Department of Paediatrics, Semmelweis University, Tűzoltó utca 7-9, Budapest 1094, Hungary
| |
Collapse
|
19
|
Chilian B, Abdollahpour H, Bierhals T, Haltrich I, Fekete G, Nagel I, Rosenberger G, Kutsche K. Dysfunction of SHANK2 and CHRNA7 in a patient with intellectual disability and language impairment supports genetic epistasis of the two loci. Clin Genet 2013; 84:560-5. [PMID: 23350639 DOI: 10.1111/cge.12105] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 01/15/2023]
Abstract
Synaptopathies constitute a group of neurological diseases including autism spectrum disorders (ASD) and intellectual disability (ID). They have been associated with mutations in genes encoding proteins important for the formation and stabilization of synapses, such as SHANK1-3. Loss-of-function mutations in the SHANK genes have been identified in individuals with ASD and ID suggesting that other factors modify the neurological phenotype. We report a boy with severe ID, behavioral anomalies, and language impairment who carries a balanced de novo triple translocation 46,XY,t(11;17;19)(q13.3;q25.1;q13.42). The 11q13.3 breakpoint was found to disrupt the SHANK2 gene. The patient also carries copy number variations at 15q13.3 and 10q22.11 encompassing ARHGAP11B and two synaptic genes. The CHRNA7 gene encoding α7-nicotinic acetylcholine receptor subunit and the GPRIN2 gene encoding G-protein-regulated inducer of neurite growth 2 were duplicated. Co-occurrence of a de novo SHANK2 mutation and a CHRNA7 duplication in two reported patients with ASD and ID as well as in the patient with t(11;17;19), severe ID and behavior problems suggests convergence of these genes on a common synaptic pathway. Our results strengthen the oligogenic inheritance model and highlight the presence of a large effect mutation and modifier genes collectively determining phenotypic expression of the synaptopathy.
Collapse
Affiliation(s)
- B Chilian
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Haltrich I, Csóka M, Kovács G, Török D, Alpár D, Ottoffy G, Fekete G. Six cases of rare gene amplifications and multiple copy of fusion gene in childhood acute lymphoblastic leukemia. Pathol Oncol Res 2013; 19:123-8. [PMID: 22528566 DOI: 10.1007/s12253-012-9533-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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] [Received: 11/25/2011] [Accepted: 04/08/2012] [Indexed: 11/28/2022]
Abstract
Cytogenetic aberrations are very important factors in risk assessment of childhood hematological malignancies. We report six childhood acute lymphoid leukemia (ALL) cases with rare cytogenetic aberrations: five with RUNX1, ABL1 or MLL proto-oncogene amplification and one case of multiple copies of ETV6/RUNX1 fusion genes. The simultaneous presence of two adverse genetic aberrations is of special interest: ETV6-RUNX1 fusion gene is associated with good prognosis and intrachromosomal amplification of the homologue RUNX1 gene is associated with poor prognosis. We also report a patient with MLL amplification, a unique finding in childhood T-ALL. Report of these subtle rearrangements contributes to our understanding of diagnostic and prognostic significance of these rare cytogenetic abnormalities.
Collapse
Affiliation(s)
- Irén Haltrich
- 2nd Department of Pediatrics, Faculty of Medicine, Semmelweis University, 1094 Budapest, Tűzoltó utca 7-9, Hungary.
| | | | | | | | | | | | | |
Collapse
|
21
|
Tegze B, Szállási Z, Haltrich I, Pénzváltó Z, Tóth Z, Likó I, Gyorffy B. Parallel evolution under chemotherapy pressure in 29 breast cancer cell lines results in dissimilar mechanisms of resistance. PLoS One 2012; 7:e30804. [PMID: 22319589 PMCID: PMC3271089 DOI: 10.1371/journal.pone.0030804] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 12/21/2011] [Indexed: 11/18/2022] Open
Abstract
Background Developing chemotherapy resistant cell lines can help to identify markers of resistance. Instead of using a panel of highly heterogeneous cell lines, we assumed that truly robust and convergent pattern of resistance can be identified in multiple parallel engineered derivatives of only a few parental cell lines. Methods Parallel cell populations were initiated for two breast cancer cell lines (MDA-MB-231 and MCF-7) and these were treated independently for 18 months with doxorubicin or paclitaxel. IC50 values against 4 chemotherapy agents were determined to measure cross-resistance. Chromosomal instability and karyotypic changes were determined by cytogenetics. TaqMan RT-PCR measurements were performed for resistance-candidate genes. Pgp activity was measured by FACS. Results All together 16 doxorubicin- and 13 paclitaxel-treated cell lines were developed showing 2–46 fold and 3–28 fold increase in resistance, respectively. The RT-PCR and FACS analyses confirmed changes in tubulin isofom composition, TOP2A and MVP expression and activity of transport pumps (ABCB1, ABCG2). Cytogenetics showed less chromosomes but more structural aberrations in the resistant cells. Conclusion We surpassed previous studies by parallel developing a massive number of cell lines to investigate chemoresistance. While the heterogeneity caused evolution of multiple resistant clones with different resistance characteristics, the activation of only a few mechanisms were sufficient in one cell line to achieve resistance.
Collapse
Affiliation(s)
- Bálint Tegze
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Primary genetic abnormalities of leukemia cells have important prognostic significance in childhood acute leukemia. In the last two years 30 newly diagnosed or recurrent childhood ALL bone marrow samples were analyzed for chromosomal abnormalities with conventional G-banding and interphase-fluorescence in situ hybridization (I-FISH) using probes to detect BCR/ABL fusions, cryptic TEL/AML1 and MLL rearrangements and p16(9p21) tumor suppressor gene deletions. G-banded karyotype analysis found clonal chromosomal aberrations in 50% of cases. With the use of complementary I-FISH techniques, ALL-specific structural and numerical changes could be identified in 70% of the patients. Nine cases (30%) had subtle chromosomal aberrations with prognostic importance that had not been detected in G-banded analysis. Conventional G-banding yielded additional information (rare and complex structural aberrations) in 19% of patients. The most common aberration (30%) was AML1 copy number increase present in G-banded hyperdiploid karyotype as a chromosome 21 tetrasomy in the majority of cases; one case displayed 5-6 copies and in another case amplification of AML1 gene on der(21) was combined with TEL/AML1 fusion of the homologue AML1 gene and deletion of the remaining TEL allele. High hiperdiploidy was detected in 6 cases, in one patient with normal G-banding karyotype. TEL/AML1 fusion signals were identified in four patients. Deletion of p16 locus was found in eight cases (23%), of which only two had cytogenetically visible rearrangements. G-banding in combination with I-FISH has produced major improvements in the sensitivity and accuracy of cytogenetic analysis of ALL patients and this method helps to achieve a more precise identification of different risk categories in order to choose the optimal treatment.
Collapse
Affiliation(s)
- Irén Haltrich
- Semmelweis Egyetem II. sz. Gyermekgyógyászati Klinika 1094 Budapest Tuzoltó utca 7-9.
| | | | | | | |
Collapse
|
23
|
Haltrich I, Csóka M, Kovács G, Fekete G. [Intrachromosomal amplification of AML1 gene in childhood acute lymphoblastic leukemia]. Orv Hetil 2008; 149:1143-6. [PMID: 18539581 DOI: 10.1556/oh.2008.28388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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]
Abstract
The introduction of routine molecular cytogenetic assays enabled us to reveal hitherto unknown genetic disorders of childhood acute leukemias. Of special interest is the recognition of those rare cytogenetic mutations of negative prognostic value, which are associated with well-known markers of good prognosis. In our present study we review a novel cytogenetic mutation typical for childhood B-cell ALL, the intrachromosomal amplification of chromosome 21, which requires high-risk therapy irrespective of other risk factors, and which is associated with a cryptic 12;21 translocation of good prognostic value.
Collapse
Affiliation(s)
- Irén Haltrich
- Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Gyermekgyógyászati Klinika, Budapest.
| | | | | | | |
Collapse
|
24
|
Haltrich I, Kovács G, Csóka M, Jakab Z, Fekete G. P065 Cytogenetic and FISH findings are complementary in childhood ALL. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70143-1] [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: 10/22/2022]
|
25
|
Csóka M, Szatmáry B, M¨uller J, Erlaky H, Haltrich I, Kovács G. P152 The role of FDG-PET/CT in follow-up of children with lymphoma. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70231-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: 11/16/2022]
|
26
|
Haltrich I, Kost-Alimova M, Kovács G, Klein G, Fekete G, Imreh S. Multipoint interphase FISH analysis of chromosome 3 abnormalities in 28 childhood AML patients. Eur J Haematol 2006; 76:124-33. [PMID: 16405433 DOI: 10.1111/j.1600-0609.2005.00576.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 12/16/2022]
Abstract
We detected non-random 3p losses and 3q gains on well-determined regions in both murine and human tumors using a microcell hybrid-based model system called 'elimination test'. We suggest that these are general malignancy-associated aberrations not necessarily linked to a particular tissue of origin. To examine chromosome 3 abnormalities, in 28 childhood acute myeloid leukemia bone marrow samples, we performed interphase multipoint-fluorescence in situ hybridization using 84 chromosome 3-specific probes and detected clonal chromosome 3 aberrations in nine cases, which is of a higher frequency than the previously reported one. In 3/28 children, a chromosome 3 abnormality was detected which was not visible using conventional cytogenetic analysis. We did not detect any 3p deletion. Increased copy number of 3q was found in four cases with trisomy of whole chromosome 3 and one case with 3q tetrasomy (isodisomy). We identified rare structural rearrangements in childhood acute myeloblastic leukemia, involving 3q21 and 3q26 loci around RPN1 and MDS1/EVI1 respectively. The poor outcome in pediatric patients with 3q rearrangements appears to be quite uniform.
Collapse
Affiliation(s)
- Irén Haltrich
- Department of Pediatrics, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
| | | | | | | | | | | |
Collapse
|
27
|
Haltrich I, Kost-Alimova M, Kovács G, Kriván G, Tamáska J, Klein G, Fekete G, Imreh S. Jumping translocation of 17q11∼qter and 3q25∼q28 duplication in a variant Philadelphia t(9;14;22)(q34;q32;q11) in a childhood chronic myelogenous leukemia. ACTA ACUST UNITED AC 2006; 164:74-80. [PMID: 16364767 DOI: 10.1016/j.cancergencyto.2005.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 03/11/2005] [Revised: 06/01/2005] [Accepted: 06/02/2005] [Indexed: 11/24/2022]
Abstract
The virtually obligatory presence of the Philadelphia chromosome may suggest a causal homogeneity, but chronic myelogenous leukemia (CML) is a clinically heterogeneous disease. This may be a consequence of the variable BCR breakpoints on chromosome 22 and of nonrandom secondary chromosomal abnormalities. We present the case of a boy, age 12, investigated in blastic phase of CML. Karyotyping with conventional and multiplex fluorescence in situ hybridization (FISH and M-FISH) karyotyping, complemented with reverse transcriptase-polymerase chain reaction, identified a variant Philadelphia translocation t(9;14;22)(q34;q32;q11) involving a cryptic BCR/ABL fusion with formation of the p190(Bcr-Abl) oncoprotein. M-FISH revealed also an unbalanced jumping translocation of 17q11 approximately qter alternatively present on chromosomes 14 or 20, apparently hithertofore unreported in hematological malignancies. Another secondary aberration, dup(3)(q25q28), was revealed by multipoint interphase FISH (mpI-FISH). Gain of this region is known in adult hematological malignancies and solid tumors, suggesting its general involvement in tumor initiation or progression (or both), regardless of tissue origin.
Collapse
Affiliation(s)
- Irén Haltrich
- Semmelweis University, Faculty of Medicine, II. Department of Pediatrics, Budapest, Hungary
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Haltrich I, Kost-Alimova M, Kovács G, Kriván G, Dobos M, Imreh S, Fekete G. [Identification of 3q21q26 syndrome by "multipoint" interphase FISH analyses in childhood myeloid leukemia]. Magy Onkol 2005; 49:141-147. [PMID: 16249810] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Accepted: 03/31/2005] [Indexed: 05/24/2023]
Abstract
Cytogenetic syndrome involving bands 3q21 and 3q26, known as "3q21q26 syndrome" has been observed in adult patients with acute myelogenous leukemia (0.5-2%), chronic myelogenous leukemia in blast crisis (20%), myelodysplastic syndromes and myeloproliferative disorders. In the present study bone marrow samples from two boys (12 and 16 years), diagnosed with CML and AML respectively, were investigated using conventional cytogenetic methods, interphase "multipoint" fluorescence in situ hybridization (FISH), dual color-FISH and multiplex FISH. The "multipoint" FISH analysis identified in de novo childhood AML case an inv(3)(q21q26) and a complex 3q rearrangement including inversion and duplication in the CML case. The "3q21q26 syndrome" is associated with normal or elevated platelet counts with marked abnormalities of megakaryocytopoiesis, involvement of multiple hematopoietic lineages. The affected patients were resistant to conventional chemotherapy and had a short survival. This syndrome is very rare in de novo childhood AML, and simultaneous presence of 3q inversion and duplication, to our knowledge, has not yet been identified in hematological malignancies. The results of our study emphasize the importance of classical and modern cytogenetic analysis in the diagnosis of hematologic malignancies, because in the majority of cases they can provide additional diagnostic information for the clinicians in deciding the best therapeutic approach, precise classification and prognosis of the disease.
Collapse
Affiliation(s)
- Irén Haltrich
- II.sz Gyermekgyógyászati Klinika, Semmelweis Egyetem, Altalános Orvostudományi Kar, Budapest 1094, Hungary.
| | | | | | | | | | | | | |
Collapse
|
29
|
Haltrich I, Müller J, Szabó J, Kovács G, Kóos R, Poros A, Dobos M, Fekete G. Donor-cell myelodysplastic syndrome developing 13 years after marrow grafting for aplastic anemia. Cancer Genet Cytogenet 2003; 142:124-8. [PMID: 12699888 DOI: 10.1016/s0165-4608(02)00804-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Donor-cell-derived hematopoietic malignancy is a rare event after bone marrow transplantation. Most cases in the literature occurred within the first year. We present a rare case of a female patient who had a bone marrow transplant for severe aplastic anemia (SAA) at the age of two and a half years from her human leukocyte antigen-identical brother. She developed a myelodysplastic syndrome (refractory cytopenia with multilineage dysplasia) 12 years later. Initially, the malignant clone was of recipient origin, but within several months, progression to a clinically more aggressive refractory anemia with excess blasts (RAEB) was accompanied by the outgrowth of a new clone of donor origin. In this report we provide evidence proving that the patient's final malignant clone arose in donor cells: cytogenetic analysis of the marrow showed a male karyotype and a t(3;21)(q26;q21) in all 62 metaphases analyzed. Interphase fluorescence in situ hybridization showed that all identifiable cells contained the Y chromosome. We conclude that donor-cell-derived hematopoietic malignancy after bone marrow transplantation can occur even after many years. We believe that the 13 years that elapsed between the transplant and the development of RAEB in our case represent the longest latency period in the literature.
Collapse
Affiliation(s)
- Irén Haltrich
- II Department of Pediatrics, Faculty of Medicine, Semmelweis University, H-1094 Budapest, Hungary.
| | | | | | | | | | | | | | | |
Collapse
|