1. Diagnostic high-throughput sequencing of 2396 patients with bleeding, thrombotic, and platelet disorders
- Author
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Minka J A Vries, Alexander Tolios, Johanna Gebhart, Ilenia Simeoni, Will Thomas, Stefanie Hofer, Matthias Haimel, Sofia Papadia, Keith Gomez, Daniel Greene, Rutendo Mapeta, Christopher J. Penkett, Willem H. Ouwehand, Michael Laffan, Kate Downes, Ernest Turro, Suthesh Sivapalaratnam, Louise C. Daugherty, Yvonne M. C. Henskens, Karyn Megy, Nick Gleadall, Howard Martin, Ingrid Pabinger, Martin Besser, Stephen Abbs, Andrew D Mumford, Daniel Duarte, Jonathan Stephens, Shoshana Revel-Vilk, Namir Al Hasso, Salih Tuna, Olga Shamardina, Sri V V Deevi, Chantal Thys, Emily Symington, Kathleen Freson, Nichola Cooper, Imperial College Healthcare NHS Trust- BRC Funding, RS: CARIM - R1.04 - Clinical thrombosis and haemostasis, RS: CARIM - R1 - Thrombosis and haemostasis, Promovendi CD, Biochemie, Faculteit FHML Centraal, MUMC+: DA CDL Algemeen (9), and RS: Carim - B04 Clinical thrombosis and Haemostasis
- Subjects
Male ,0301 basic medicine ,Platelet disorder ,Immunology ,Gene Dosage ,Hemorrhage ,Context (language use) ,VARIANTS ,030204 cardiovascular system & hematology ,BIOBANK ,Bioinformatics ,Biochemistry ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Copy-number variation ,Hemostatic function ,1102 Cardiorespiratory Medicine and Haematology ,MUTATION ,GENETIC DIAGNOSIS ,Blood Platelet Disorders ,INHERITED THROMBOCYTOPENIA ,Hemostasis ,business.industry ,High-Throughput Nucleotide Sequencing ,1103 Clinical Sciences ,Thrombosis ,Oligogenic Inheritance ,NIHR BioResource ,Cell Biology ,Hematology ,medicine.disease ,DYSFUNCTION ,Bleeding diathesis ,030104 developmental biology ,1114 Paediatrics and Reproductive Medicine ,Female ,business - Abstract
A targeted high-throughput sequencing (HTS) panel test for clinical diagnostics requires careful consideration of the inclusion of appropriate diagnostic-grade genes, the ability to detect multiple types of genomic variation with high levels of analytic sensitivity and reproducibility, and variant interpretation by a multidisciplinary team (MDT) in the context of the clinical phenotype. We have sequenced 2396 index patients using the ThromboGenomics HTS panel test of diagnostic-grade genes known to harbor variants associated with rare bleeding, thrombotic, or platelet disorders (BTPDs). The molecular diagnostic rate was determined by the clinical phenotype, with an overall rate of 49.2% for all thrombotic, coagulation, platelet count, and function disorder patients and a rate of 3.2% for patients with unexplained bleeding disorders characterized by normal hemostasis test results. The MDT classified 745 unique variants, including copy number variants (CNVs) and intronic variants, as pathogenic, likely pathogenic, or variants of uncertain significance. Half of these variants (50.9%) are novel and 41 unique variants were identified in 7 genes recently found to be implicated in BTPDs. Inspection of canonical hemostasis pathways identified 29 patients with evidence of oligogenic inheritance. A molecular diagnosis has been reported for 894 index patients providing evidence that introducing an HTS genetic test is a valuable addition to laboratory diagnostics in patients with a high likelihood of having an inherited BTPD. ispartof: BLOOD vol:134 issue:23 pages:2082-2091 ispartof: location:United States status: published
- Published
- 2019
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