Association of biallelic BRCA2/FANCD1 mutations with spontaneous chromosomal instability and solid tumors of childhood.
The clinical, cytogenetic, and molecular findings of 2 Fanconi anemia (FA) subtype D1 kindreds, initially identified through a young child with a solid tumor (medullobastoma, Wilms tumor), are described. Each kindred subsequently had a second affected child; one developed Wilms tumor followed by a medulloblastoma, and the other developed T-lineage acute lymphoblastic leukemia. Cytogenetic studies revealed an unusually high spontaneous chromosome aberration rate, contrasting with other FA subtypes. Molecular analysis revealed biallelic BRCA2/FANCD1 mutations. The patients did not exhibit bone marrow failure. Our studies suggest that the D1 subtype represents a severe end of the cytogenetic spectrum within FA, consistent with a critical downstream role of BRCA2 in the FA pathway. Furthermore, this FA subgroup may be preferentially associated with an increased predisposition to solid tumors in early childhood. Recognition of this constellation of findings has significant implications for medical management and genetic counseling of FA families.
Hirsch
Betsy
B
Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, USA.
Shimamura
Akiko
A
Moreau
Lisa
L
Baldinger
Shari
S
Hag-alshiekh
Maha
M
Bostrom
Bruce
B
Sencer
Susan
S
D'Andrea
Alan D
AD
D000741:Anemia, Aplastic / Q000235:genetics; D020295:Brain Stem Neoplasms / Q000235:genetics; D002648:Child; D043171:Chromosomal Instability / Q000235:genetics*; D024522:Genes, BRCA2; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics; D008527:Medulloblastoma / Q000235:genetics; D009153:Mutagens; D009369:Neoplasms / Q000235:genetics*; D035781:Siblings; D009396:Wilms Tumor / Q000235:genetics
D009153:Mutagens