title: Combine-ARMS: a rapid and cost-effective protocol for molecular characterization of beta-thalassemia in Malaysia.
abstract: Beta-thalassemia major patients have chronic anemia and are dependent on blood transfusions to sustain life. Molecular characterization and prenatal diagnosis of beta3-thalassemia is essential in Malaysia because about 4.5% of the population are heterozygous carriers for beta-thalassemia. The high percentage of compound heterozygosity (47.62%) found in beta-thalassemia major patients in the Thalassaemia Registry, University of Malaya Medical Centre (UMMC), Malaysia, also supports a need for rapid, economical, and sensitive protocols for the detection of beta-thalassemia mutations. Molecular characterization of beta-thalassemia mutations in Malaysia is currently carried out using ARMS, which detects a single beta-thalassemia mutation per PCR reaction. We developed and evaluated Combine amplification refractory mutation system (C-ARMS) techniques for efficient molecular detection of two to three beta-thalassemia mutations in a single PCR reaction. Three C-ARMS protocols were evaluated and established for molecular characterization of common beta-thalassemia mutations in the Malay and Chinese ethnic groups in Malaysia. Two C-ARMS protocols (cd 41-42/IVSII #654 and -29/cd 71-72) detected the beta-thalassemia mutations in 74.98% of the Chinese patients studied. The CARMS for cd 41-42/IVSII #654 detected beta-thalassemia mutations in 72% of the Chinese families. C-ARMS for cd 41-42/IVSI #5/cd 17 allowed detection of beta-thalassemia mutations in 36.53% of beta-thalassemia in the Malay patients. C-ARMS for cd 41-42/IVSI #5/cd 17 detected beta-thalassemia in 45.54% of the Chinese patients. We conclude that C-ARMS with the ability to detect two to three mutations in a single reaction provides more rapid and cost-effective protocols for beta-thalassemia prenatal diagnosis and molecular analysis programs in Malaysia.
authors.affiliation: Department of Allied Health Sciences, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: K L
authors.initials: KL
authors.lastname: Tan
authors.forename: J A
authors.initials: JA
authors.lastname: Tan
authors.forename: Y C
authors.initials: YC
authors.lastname: Wong
authors.forename: Y C
authors.initials: YC
authors.lastname: Wee
authors.forename: M K
authors.initials: MK
authors.lastname: Thong
authors.forename: S F
authors.initials: SF
authors.lastname: Yap
mesh_terms: D044466:Asian People / Q000235:genetics; D002681:China / Q000208:ethnology; D004252:DNA Mutational Analysis / Q000191:economics* / Q000379:methods*; D004586:Electrophoresis; D005260:Female; D006579:Heterozygote; D006801:Humans; D008296:Malaysia; D009154:Mutation / Q000235:genetics*; D016133:Polymerase Chain Reaction / Q000379:methods; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000191:economics / Q000379:methods; D012680:Sensitivity and Specificity; D017086:beta-Thalassemia / Q000175:diagnosis* / Q000235:genetics*