The diversity of mutations and clinical outcomes for ELANE-associated neutropenia. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Makaryan, Vahagn; Zeidler, Cornelia; Bolyard, Audrey Anna; Skokowa, Julia; Rodger, Elin; Kelley, Merideth L.; Boxer, Laurence A.; Bonilla, Mary Ann; Newburger, Peter E.; Shimamura, Akiko; Zhu, Bin; Rosenberg, Philip S.; Link, Daniel C.; Welte, Karl; Dale, David C.
• Is Part Of: Current opinion in hematology. Volume 22:Issue 1(2015:Jan.)
• Publication Date: 2015-01
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1097/MOH.0000000000000105
• Languages: English
• ISSNs: 1065-6251

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Purpose of review</title> <p>Mutations in the gene for neutrophil elastase, <italic>ELANE</italic>, cause cyclic neutropenia (CyN) and severe congenital neutropenia (SCN). This study summarized data from the Severe Chronic Neutropenia International Registry (SCNIR) on genotype–phenotype relationships of <italic>ELANE</italic> mutations to important clinical outcomes. We also summarize findings for <italic>ELANE</italic> mutations not observed in SCNIR patients.</p> </sec> <sec> <title>Recent findings</title> <p>There were 307 SCNIR patients with 104 distinctive <italic>ELANE</italic> mutations who were followed longitudinally for up to 27 years. The <italic>ELANE</italic> mutations were diverse; there were 65 single amino acid substitutions; 61 of these mutations (94%) were 'probably' or 'possibly damaging' by PolyPhen-2 analysis, and one of the 'benign' mutations was associated with two cases of acute myeloid leukemia (AML). All frame-shift mutations (19/19) were associated with the SCN. The pattern of mutations in the SCN versus CyN was significantly different (<italic>P</italic> < 10<sup>–4</sup>), but some mutations were observed in both groups (overlapping mutations). The cumulative incidence of severe adverse events, that is, myelodysplasia, AML, stem cell transplantation, or deaths was significantly greater for patients with SCN versus those with CyN or overlapping mutations. Specific mutations (i.e. G214R or C151Y) had a high risk for evolution to AML.</p> </sec> <sec> <title>Summary</title> <p>Sequencing is useful for predicting outcomes of <italic>ELANE</italic>-associated neutropenia.</p> </sec> </abstract>