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dc.contributor.authorBlombery, Piers-
dc.contributor.authorFox, Lucy-
dc.contributor.authorRyland, Georgina L-
dc.contributor.authorThompson, Ella R-
dc.contributor.authorLickiss, Jennifer-
dc.contributor.authorMcBean, Michelle-
dc.contributor.authorYerneni, Satwica-
dc.contributor.authorHughes, David-
dc.contributor.authorGreenway, Anthea-
dc.contributor.authorMechinaud, Francoise-
dc.contributor.authorWood, Erica M-
dc.contributor.authorLieschke, Graham J-
dc.contributor.authorSzer, Jeff-
dc.contributor.authorBarbaro, Pasquale-
dc.contributor.authorRoy, John-
dc.contributor.authorWight, Joel C-
dc.contributor.authorLynch, Elly-
dc.contributor.authorMartyn, Melissa-
dc.contributor.authorGaff, Clara-
dc.contributor.authorRitchie, David-
dc.identifier.citationHaematologica 2021; 106(1): 64-73-
dc.description.abstractBone marrow failure (BMF) related to hypoplasia of haematopoietic elements in the bone marrow is a heterogeneous clinical entity with a broad differential diagnosis including both inherited and acquired causes. Accurate diagnostic categorisation is critical to optimal patient care and detection of genomic variants in these patients may provide this important diagnostic and prognostic information. We performed real-time, accredited (ISO15189) comprehensive genomic characterisation including targeted sequencing and whole exome sequencing in 115 patients with BMF syndrome (median age 24 years, range 3 months - 81 years). In patients with clinical diagnoses of inherited BMF syndromes, acquired BMF syndromes or clinically unclassifiable BMF we detected variants in 52% (12/23), 53% (25/47) and 56% (25/45) respectively. Genomic characterisation resulted in a change of diagnosis in 30/115 (26%) including the identification of germline causes for 3/47 and 16/45 cases with pre-test diagnoses of acquired and clinically unclassifiable BMF respectively. The observed clinical impact of accurate diagnostic categorisation included choice to perform allogeneic stem cell transplantation, disease-specific targeted treatments, identification of at-risk family members and influence of sibling allogeneic stem cell donor choice. Multiple novel pathogenic variants and copy number changes were identified in our cohort including in TERT, FANCA, RPS7 and SAMD9. Whole exome sequence analysis facilitated the identification of variants in two genes not typically associated with a primary clinical manifestation of BMF but also demonstrated reduced sensitivity for detecting low level acquired variants. In conclusion, genomic characterisation can improve diagnostic categorisation of patients presenting with hypoplastic BMF syndromes and should be routinely performed in this group of patients.-
dc.subjectBone Marrow Failure-
dc.subjectCytogenetics and Molecular Genetics-
dc.subjectMyelodysplastic Syndromes-
dc.titleUtility of clinical comprehensive genomic characterisation for diagnostic categorisation in patients presenting with hypocellular bone marrow failure syndromes.-
dc.typeJournal Article-
dc.identifier.affiliationUniversity of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australiaen
dc.identifier.affiliationClinical Haematology, Peter MacCallum Cancer Centre, Melbourne, Australiaen
dc.identifier.affiliationClinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne, Australiaen
dc.identifier.affiliationMelbourne Genomics Health Alliance, Parkville VIC, Australiaen
dc.identifier.affiliationDepartment of Haematology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationChildren Health Queensland and University of Queensland, South Brisbane QLD, Australiaen
dc.identifier.affiliationTransfusion Research Unit, Monash University, Melbourne, Australiaen
dc.identifier.affiliationRoyal Children's Hospital, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australiaen
dc.type.austinJournal Article-, Joel C
item.openairetypeJournal Article-
item.fulltextNo Fulltext- Haematology- Newton-John Cancer Wellness and Research Centre-
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