Impact of genetic variants on haematopoiesis in patients with thrombocytopenia absent radii (TAR) syndrome

Br J Haematol. 2017 Nov;179(4):606-617. doi: 10.1111/bjh.14913. Epub 2017 Aug 31.

Abstract

Thrombocytopenia absent radii (TAR) syndrome is clearly defined by the combination of radial aplasia and reduced platelet counts. The genetics of TAR syndrome has recently been resolved and comprises a microdeletion on Chromosome 1 including the RBM8A gene and a single nucleotide polymorphism (SNP) either at the 5' untranslated region (5'UTR) or within the first intron of RBM8A. Although phenotypically readily diagnosed after birth, the genetic determination of particular SNPs in TAR syndrome harbours valuable information to evaluate disease severity and treatment decisions. Here, we present clinical data in a cohort of 38 patients and observed that platelet counts in individuals with 5'UTR SNP are significantly lower compared to patients bearing the SNP in intron 1. Moreover, elevated haemoglobin values could only be assessed in patients with 5'UTR SNP whereas white blood cell count is unaffected, indicating that frequently observed anaemia in TAR patients could also be SNP-dependent whereas leucocytosis does not correlate with genetic background. However, this report on a large cohort provides an overview of important haematological characteristics in TAR patients, facilitating evaluation of the various traits in this disease and indicating the importance of genetic validation for TAR syndrome.

Keywords: bone marrow failure; genetics; haematopoiesis; thrombocytopenia; thrombocytopenia-absent radii syndrome.

Publication types

  • Multicenter Study

MeSH terms

  • 5' Untranslated Regions / genetics
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Chromosome Deletion
  • Chromosomes, Human, Pair 1 / genetics
  • Cohort Studies
  • Congenital Bone Marrow Failure Syndromes
  • Female
  • Genetic Variation*
  • Hematopoiesis / genetics*
  • Humans
  • Infant
  • Infant, Newborn
  • Introns / genetics
  • Male
  • Platelet Count
  • Polymorphism, Single Nucleotide / genetics
  • RNA-Binding Proteins / genetics
  • Radius / pathology
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / genetics*
  • Thrombocytopenia / pathology
  • Upper Extremity Deformities, Congenital / diagnosis
  • Upper Extremity Deformities, Congenital / genetics*
  • Upper Extremity Deformities, Congenital / pathology
  • Young Adult

Substances

  • 5' Untranslated Regions
  • RBM8A protein, human
  • RNA-Binding Proteins

Supplementary concepts

  • Absent radii and thrombocytopenia