Identification of 2 novel noncoding variants in patients with Diamond-Blackfan anemia syndrome by whole genome sequencing

Abstract: Diamond-Blackfan anemia syndrome (DBAS) is a rare congenital disorder with variable penetrance and expressivity and is characterized by pure red cell aplasia that typically manifests as early-onset chronic macrocytic or normocytic anemia and is often associated with other congenital anomal...

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Main Authors: Ting Wen, Steven E. Boyden, Caleb M. Hocutt, Robert G. Lewis, Erin E. Baldwin, Jennie Vagher, Ashley Andrews, Thomas J. Nicholas, Alexander Chapin, Elaine M. Fan, Lorenzo D. Botto, Pinar Bayrak-Toydemir, Rong Mao, Jessica A. Meznarich
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Blood Advances
Online Access:http://www.sciencedirect.com/science/article/pii/S2473952925001405
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author Ting Wen
Steven E. Boyden
Caleb M. Hocutt
Robert G. Lewis
Erin E. Baldwin
Jennie Vagher
Ashley Andrews
Thomas J. Nicholas
Alexander Chapin
Elaine M. Fan
Lorenzo D. Botto
Pinar Bayrak-Toydemir
Rong Mao
Jessica A. Meznarich
author_facet Ting Wen
Steven E. Boyden
Caleb M. Hocutt
Robert G. Lewis
Erin E. Baldwin
Jennie Vagher
Ashley Andrews
Thomas J. Nicholas
Alexander Chapin
Elaine M. Fan
Lorenzo D. Botto
Pinar Bayrak-Toydemir
Rong Mao
Jessica A. Meznarich
author_sort Ting Wen
collection DOAJ
description Abstract: Diamond-Blackfan anemia syndrome (DBAS) is a rare congenital disorder with variable penetrance and expressivity and is characterized by pure red cell aplasia that typically manifests as early-onset chronic macrocytic or normocytic anemia and is often associated with other congenital anomalies. DBAS is etiologically heterogeneous with >20 known DBAS-associated genes that encode small and large ribosomal protein subunits and an inheritance pattern that is largely autosomal dominant or sporadic. We report 2 DBAS cases with previous negative genetic testing, which included targeted gene panels, karyotype analysis, chromosome breakage analysis, and whole exome sequencing. Although clinical whole genome sequencing (WGS) was initially negative, in-depth reanalysis identified 2 novel noncoding variants in the RPS gene family, namely a maternally inherited splicing variant at the end of the first noncoding exon in RPS7 (NM_001011.4, c.-19G>C) in family 1 and a deep intronic de novo variant in RPS19 (NM_001022.4, c.172+350C>T) in family 2. In family 1, several maternal relatives were identified who shared the same variant through cascade testing; clinically, they exhibited variable degrees of anemia and elevated erythrocyte adenosine deaminase activity, a marker for DBAS. RNA sequencing analysis demonstrated deleterious functional consequences for both noncoding variants. In case 1, hematopoietic stem cell transplant with an unaffected matched sibling donor who did not carry the variant successfully cured the congenital anemia. This study identified novel noncoding variants and underscores the clinical utility of WGS in accelerating diagnosis and improving care for rare genetic disorders, particularly when timely treatment decisions are critically important.
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spelling doaj-art-9d6c520365564cbc8e40fc75fd93aa912025-08-20T01:51:45ZengElsevierBlood Advances2473-95292025-05-019102443245210.1182/bloodadvances.2024015347Identification of 2 novel noncoding variants in patients with Diamond-Blackfan anemia syndrome by whole genome sequencingTing Wen0Steven E. Boyden1Caleb M. Hocutt2Robert G. Lewis3Erin E. Baldwin4Jennie Vagher5Ashley Andrews6Thomas J. Nicholas7Alexander Chapin8Elaine M. Fan9Lorenzo D. Botto10Pinar Bayrak-Toydemir11Rong Mao12Jessica A. Meznarich13ARUP Laboratories, Salt Lake City, UT; Department of Pathology, University of Utah, Salt Lake City, UT; Department of Pathology and Laboratory Medicine, Henry Ford Hospital, Detroit, MI; Correspondence: Ting Wen, Department of Pathology, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202;Department of Human Genetics, Utah Center for Genetic Discovery, Salt Lake City, UTDivision of Pediatric Hematology and Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT; Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UTARUP Laboratories, Salt Lake City, UT; Department of Pathology, University of Utah, Salt Lake City, UTPrimary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT; Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, UTHuntsman Cancer Institute, University of Utah, Salt Lake City, UTPrimary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT; Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, UTDepartment of Human Genetics, Utah Center for Genetic Discovery, Salt Lake City, UTARUP Laboratories, Salt Lake City, UTDivision of Pediatric Hematology and Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT; Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UTDivision of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, UTARUP Laboratories, Salt Lake City, UT; Department of Pathology, University of Utah, Salt Lake City, UTARUP Laboratories, Salt Lake City, UT; Department of Pathology, University of Utah, Salt Lake City, UTDivision of Pediatric Hematology and Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT; Primary Children’s Hospital, Intermountain Healthcare, Salt Lake City, UT; Jessica A. Meznarich, Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84108;Abstract: Diamond-Blackfan anemia syndrome (DBAS) is a rare congenital disorder with variable penetrance and expressivity and is characterized by pure red cell aplasia that typically manifests as early-onset chronic macrocytic or normocytic anemia and is often associated with other congenital anomalies. DBAS is etiologically heterogeneous with >20 known DBAS-associated genes that encode small and large ribosomal protein subunits and an inheritance pattern that is largely autosomal dominant or sporadic. We report 2 DBAS cases with previous negative genetic testing, which included targeted gene panels, karyotype analysis, chromosome breakage analysis, and whole exome sequencing. Although clinical whole genome sequencing (WGS) was initially negative, in-depth reanalysis identified 2 novel noncoding variants in the RPS gene family, namely a maternally inherited splicing variant at the end of the first noncoding exon in RPS7 (NM_001011.4, c.-19G>C) in family 1 and a deep intronic de novo variant in RPS19 (NM_001022.4, c.172+350C>T) in family 2. In family 1, several maternal relatives were identified who shared the same variant through cascade testing; clinically, they exhibited variable degrees of anemia and elevated erythrocyte adenosine deaminase activity, a marker for DBAS. RNA sequencing analysis demonstrated deleterious functional consequences for both noncoding variants. In case 1, hematopoietic stem cell transplant with an unaffected matched sibling donor who did not carry the variant successfully cured the congenital anemia. This study identified novel noncoding variants and underscores the clinical utility of WGS in accelerating diagnosis and improving care for rare genetic disorders, particularly when timely treatment decisions are critically important.http://www.sciencedirect.com/science/article/pii/S2473952925001405
spellingShingle Ting Wen
Steven E. Boyden
Caleb M. Hocutt
Robert G. Lewis
Erin E. Baldwin
Jennie Vagher
Ashley Andrews
Thomas J. Nicholas
Alexander Chapin
Elaine M. Fan
Lorenzo D. Botto
Pinar Bayrak-Toydemir
Rong Mao
Jessica A. Meznarich
Identification of 2 novel noncoding variants in patients with Diamond-Blackfan anemia syndrome by whole genome sequencing
Blood Advances
title Identification of 2 novel noncoding variants in patients with Diamond-Blackfan anemia syndrome by whole genome sequencing
title_full Identification of 2 novel noncoding variants in patients with Diamond-Blackfan anemia syndrome by whole genome sequencing
title_fullStr Identification of 2 novel noncoding variants in patients with Diamond-Blackfan anemia syndrome by whole genome sequencing
title_full_unstemmed Identification of 2 novel noncoding variants in patients with Diamond-Blackfan anemia syndrome by whole genome sequencing
title_short Identification of 2 novel noncoding variants in patients with Diamond-Blackfan anemia syndrome by whole genome sequencing
title_sort identification of 2 novel noncoding variants in patients with diamond blackfan anemia syndrome by whole genome sequencing
url http://www.sciencedirect.com/science/article/pii/S2473952925001405
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