Germline mutations in BRCA2: shared genetic susceptibility to breast cancer, early onset leukemia, and Fanconi anemia.
The breast cancer susceptibility gene BRCA2 has recently been identified as identical to the Fanconi anemia (FA) gene FANCD1. Here we expand the clinical implications of this discovery. Notably, we identified 6 children in 5 kindreds exhibiting the co-occurrence of BRCA2 mutations, FA, and early onset acute leukemia. Leukemia occurred at a median of 2.2 years of age in the BRCA2 patients in contrast to a median onset of 13.4 years in all other FA patients in the International Fanconi Anemia Registry (IFAR; P <.0001). Breast cancer was noted in 4 of the 5 kindreds. Of the 6 children with leukemia, 4 were treated with bone marrow transplantation and 2 are alive at 3 and 9 months after treatment. Our results suggest that BRCA2 testing should be considered in all patients with FA in whom the complementation group cannot be defined or in whom leukemia is diagnosed at or before 5 years of age.
Wagner
John E
JE
Division of Pediatric Hematology, Oncology, and Blood Marrow Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA. wagne002@umn.edu
Tolar
Jakub
J
Levran
Orna
O
Scholl
Thomas
T
Deffenbaugh
Amie
A
Satagopan
Jaya
J
Ben-Porat
Leah
L
Mah
Katherine
K
Batish
Sat Dev
SD
Kutler
David I
DI
MacMillan
Margaret L
ML
Hanenberg
Helmut
H
Auerbach
Arleen D
AD
D000208:Acute Disease; D000293:Adolescent; D017668:Age of Onset; D000483:Alleles; D001483:Base Sequence; D001943:Breast Neoplasms / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D018076:DNA, Complementary / Q000235:genetics; D005199:Fanconi Anemia / Q000235:genetics*; D005260:Female; D024522:Genes, BRCA2; D018095:Germ-Line Mutation; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000235:genetics*; D008297:Male
D018076:DNA, Complementary