A high-throughput sequencing test for diagnosing inherited bleeding, thrombotic, and platelet disorders
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Inherited bleeding, thrombotic and platelet disorders (BPDs) are diseases affecting approximately 300 individuals per million births. With the exception of haemophilia and von Willebrand disease patients, a molecular analysis for patients with a BPD is often unavailable. Many specialised tests are usually required to reach a putative diagnosis and they are typically performed in a step-wise manner to control costs. This approach causes delays and a conclusive molecular diagnosis is often never reached which can compromise treatment and impede rapid identification of affected relatives. To address this unmet diagnostic need, we designed a high-throughput sequencing (HTS) platform targeting 63 genes relevant for BPDs. The platform can call single nucleotide variants (SNVs), short insertions/deletions (indels) and large copy number variants (CNVs), though not inversions, which are subjected to automated filtering for diagnostic prioritization, resulting in an average of 5.34 candidate variants per individual. We sequenced 159 and 137 samples respectively from cases with and without previously known causal variants. Among the latter group, 61 cases had clinical and laboratory phenotypes indicative of a particular molecular etiology while the remainder had ana priorihighly uncertain etiology. All previously detected variants were recapitulated and, when the etiology was suspected but unknown or uncertain, a molecular diagnosis was reached in 56 of 61 and only eight of 76 cases, respectively. The latter category highlights the need for further research into novel causes of BPDs. The ThromboGenomics platform thus provides an affordable DNA-based test to diagnose patients suspected of having a known inherited BPD.
Date Issued
2016-06-09
Date Acceptance
2016-04-07
Citation
Blood, 2016, 127 (23), pp.2791-2803
ISSN
0006-4971
Publisher
American Society of Hematology
Start Page
2791
End Page
2803
Journal / Book Title
Blood
Volume
127
Issue
23
Copyright Statement
Copyright the authors.
Sponsor
Medical Research Council (MRC)
Identifier
https://ashpublications.org/blood/article/127/23/2791/35304/A-highthroughput-sequencing-test-for-diagnosing
Grant Number
MR/J011711/1
Subjects
Science & Technology
Life Sciences & Biomedicine
Hematology
VON-WILLEBRAND-DISEASE
WISKOTT-ALDRICH SYNDROME
FACTOR-VIII GENE
UNITED-KINGDOM
GENOME
MANAGEMENT
MUTATIONS
LINKAGE
POLYMORPHISMS
POPULATION
Blood Platelet Disorders
Case-Control Studies
DNA Copy Number Variations
Female
Genetic Association Studies
Genetic Predisposition to Disease
Hemorrhage
High-Throughput Nucleotide Sequencing
Humans
Male
Mutation
Polymorphism, Single Nucleotide
Sequence Analysis, DNA
Thrombosis
Humans
Thrombosis
Blood Platelet Disorders
Genetic Predisposition to Disease
Hemorrhage
Case-Control Studies
Sequence Analysis, DNA
Mutation
Polymorphism, Single Nucleotide
Female
Male
Genetic Association Studies
DNA Copy Number Variations
High-Throughput Nucleotide Sequencing
Immunology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
Publication Status
Published
Date Publish Online
2016-06-09