期刊
CURRENT OPINION IN HEMATOLOGY
卷 22, 期 1, 页码 3-11出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOH.0000000000000105
关键词
congenital neutropenia; cyclic neutropenia; ELANE; neutropenia; neutrophil elastase
类别
资金
- NIH/NIAID [5R 24AI049393]
- Ella Jewell Foundation
- Amgen Foundation
- German Ministry of Education and Research (BMBF) [01GM0845, 01GM1010]
- NATIONAL CANCER INSTITUTE [ZIACP010181] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [R24AI049393] Funding Source: NIH RePORTER
Purpose of review Mutations in the gene for neutrophil elastase, ELANE, cause cyclic neutropenia (CyN) and severe congenital neutropenia (SCN). This study summarized data from the Severe Chronic Neutropenia International Registry (SCNIR) on genotype-phenotype relationships of ELANE mutations to important clinical outcomes. We also summarize findings for ELANE mutations not observed in SCNIR patients. Recent findings There were 307 SCNIR patients with 104 distinctive ELANE mutations who were followed longitudinally for up to 27 years. The ELANE mutations were diverse; there were 65 single amino acid substitutions; 61 of these mutations (94%) were 'probably' or 'possibly damaging' by PolyPhen-2 analysis, and one of the 'benign' mutations was associated with two cases of acute myeloid leukemia (AML). All frame-shift mutations (19/19) were associated with the SCN. The pattern of mutations in the SCN versus CyN was significantly different (P<10(-4)), but some mutations were observed in both groups (overlapping mutations). The cumulative incidence of severe adverse events, that is, myelodysplasia, AML, stem cell transplantation, or deaths was significantly greater for patients with SCN versus those with CyN or overlapping mutations. Specific mutations (i.e. G214R or C151Y) had a high risk for evolution to AML. Summary Sequencing is useful for predicting outcomes of ELANE-associated neutropenia.
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