Journal
BLOOD
Volume 112, Issue 4, Pages 1042-1047Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2008-01-135970
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Funding
- NHLBI NIH HHS [T32HL066991, T32 HL066991] Funding Source: Medline
- NIDDK NIH HHS [T32 DK060445, T32 DK60445] Funding Source: Medline
- NIGMS NIH HHS [T32 GM007526, T32 GM07526] Funding Source: Medline
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Several lines of evidence support the presence of dosage-sensitive genes on chromosome 21 that regulate leukemogenesis and hematopoiesis. We report a detailed clinical and molecular characterization of 3 patients with chronic thrombocytopenia caused by distinct constitutional microdeletions involving chromosomal region 21q22.12. The patients exhibited growth restriction, dysmorphic features, and developmental delays. One patient developed acute myelogenous leukemia (AML) at 6 years of age. All 3 deletions included the RUNX1, CLIC6, DSCR, and KCNE1 genes. Our data provide additional support for the role of RUNX1 haploinsufficiency in megakaryopoiesis and predisposition to AML. The leukemic clone had trisomy 21 resulting from duplication of chromosome 21 containing the RUNX1 deletion. This shows that genes other than RUNX1 must also play a role in AML associated with trisomy 21. We recommend that children with syndromic thrombocytopenia have clinical array-comparative genomic hybridization analysis and appropriate cytogenetic studies to facilitate our ability to provide a definitive diagnosis.
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