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DIAGNOSIS OF HEMATOPOIETIC MALIGNANCIES WITH GERMLINE PREDISPOSITION : A FILTERED WHOLE EXOME SEQUENCING APPROACH
Author(s): ,
Rafael Fernandez Carazo
Affiliations:
Genetics,CHU Liege,Liège,Belgium
,
Benjamin Koopmansch,
Affiliations:
Genetics,CHU Liege,Liège,Belgium
,
Benoit Charloteaux
Affiliations:
Genetics,CHU Liege,Liège,Belgium
,
Leonor Palmeira
Affiliations:
Genetics,CHU Liege,Liège,Belgium
Frédéric Lambert
Affiliations:
Genetics,CHU Liege,Liège,Belgium
EHA Library. Fernandez Carazo R. 06/09/21; 324162; PB1483
Rafael Fernandez Carazo
Rafael Fernandez Carazo
Contributions
Abstract

Abstract: PB1483

Type: Publication Only

Session title: Bone marrow failure syndromes incl. PNH - Clinical

Background
Inherited Haematological Malignancies are a heterogeneous group of malignancies not yet fully understood and in constant evolution.

Patients suffering of suspected inherited malignancies are often faced to poor access to rapid diagnosis due to a restricted number of analytical sites or the current use of non-comprehensive targeted panels.

Aims
We aim at developing a new NGS panel for the analysis of several haematological diseases based on a filtered whole exome sequencing approach.

Haematological diseases incorporated in the panel include myelodysplasic syndromes, acute myeloid leukemia, inherited bone marrow failure syndromes, Fanconi anemia, Diamond Blackfan anemia, dyskeratosis congenita, Telomeropathies and severe congenital neutropenia.

Methods
Clinical exome is sequenced with the SureSelect Hulan Exome V6, recovering information for about 20k genes, representing ca. 180k exons. A newly designed variant filter based on an in-house pipeline tree (Alissa Interpret) for the flagging of retained variants, allows for the selection and labeling of ca. 100 variants per patient. Variants are categorized following the ACMG guidelines for the interpretation of inherited variants and reported in the context of the patient malignancies.

The set of genes has been selected from a deep insight to the most recent literature and guidelines and covers 85 full (exonic) genes. The ncRNA gene TERC and  intronic regions from RETL1 are also included in the set.


The analytical pipeline considers the analysis of single patients, corroboration of relevant inherited germline mutations from fibroblasts and/or trio analysis including first or second relatives. Applications cover from simple diagnostic from single patients to  familiar studies or donor compatibility analysis.

Results
The proposed analytical method provides a solution for the detection of mutations in a large panel of genes involved in the cited haematological diseases. Due to the constant evolution and updates in this malignancies area, flexibility is a key concept to avoid analytical obsolescence. Due to the wide range of genes covered by the WES approach, significant genes could be further updated, with a minimal effort, to the panel.

Conclusion
We therefore aim to provide physicians with a comprehensive diagnostic panel for the diagnostic work-up of patients affected (or suspected to be affected) by inherited haematological malignancies, and related diseases enhancing the patient’s chances to benefit from a personalized medicine approach; together with a view to increase the knowledge about those (rare) conditions.

Keyword(s):

Abstract: PB1483

Type: Publication Only

Session title: Bone marrow failure syndromes incl. PNH - Clinical

Background
Inherited Haematological Malignancies are a heterogeneous group of malignancies not yet fully understood and in constant evolution.

Patients suffering of suspected inherited malignancies are often faced to poor access to rapid diagnosis due to a restricted number of analytical sites or the current use of non-comprehensive targeted panels.

Aims
We aim at developing a new NGS panel for the analysis of several haematological diseases based on a filtered whole exome sequencing approach.

Haematological diseases incorporated in the panel include myelodysplasic syndromes, acute myeloid leukemia, inherited bone marrow failure syndromes, Fanconi anemia, Diamond Blackfan anemia, dyskeratosis congenita, Telomeropathies and severe congenital neutropenia.

Methods
Clinical exome is sequenced with the SureSelect Hulan Exome V6, recovering information for about 20k genes, representing ca. 180k exons. A newly designed variant filter based on an in-house pipeline tree (Alissa Interpret) for the flagging of retained variants, allows for the selection and labeling of ca. 100 variants per patient. Variants are categorized following the ACMG guidelines for the interpretation of inherited variants and reported in the context of the patient malignancies.

The set of genes has been selected from a deep insight to the most recent literature and guidelines and covers 85 full (exonic) genes. The ncRNA gene TERC and  intronic regions from RETL1 are also included in the set.


The analytical pipeline considers the analysis of single patients, corroboration of relevant inherited germline mutations from fibroblasts and/or trio analysis including first or second relatives. Applications cover from simple diagnostic from single patients to  familiar studies or donor compatibility analysis.

Results
The proposed analytical method provides a solution for the detection of mutations in a large panel of genes involved in the cited haematological diseases. Due to the constant evolution and updates in this malignancies area, flexibility is a key concept to avoid analytical obsolescence. Due to the wide range of genes covered by the WES approach, significant genes could be further updated, with a minimal effort, to the panel.

Conclusion
We therefore aim to provide physicians with a comprehensive diagnostic panel for the diagnostic work-up of patients affected (or suspected to be affected) by inherited haematological malignancies, and related diseases enhancing the patient’s chances to benefit from a personalized medicine approach; together with a view to increase the knowledge about those (rare) conditions.

Keyword(s):

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