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Wiskott-Aldrich syndrome: a study of 577 patients defines the genotype as a biomarker for disease severity and survival

TC. Vallée, JS. Glasmacher, H. Buchner, PD. Arkwright, U. Behrends, A. Bondarenko, MJ. Browning, D. Buchbinder, A. Cattoni, L. Chernyshova, P. Ciznar, T. Cole, W. Czogała, G. Dueckers, JDM. Edgar, F. Erbey, A. Fasth, F. Ferrua, R. Formankova, E....

. 2024 ; 143 (24) : 2504-2516. [pub] 20240613

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc24013517

Wiskott-Aldrich syndrome (WAS) is a multifaceted monogenic disorder with a broad disease spectrum and variable disease severity and a variety of treatment options including allogeneic hematopoietic stem cell transplantation (HSCT) and gene therapy (GT). No reliable biomarker exists to predict disease course and outcome for individual patients. A total of 577 patients with a WAS variant from 26 countries and a median follow-up of 8.9 years (range, 0.3-71.1), totaling 6118 patient-years, were included in this international retrospective study. Overall survival (OS) of the cohort (censored at HSCT or GT) was 82% (95% confidence interval, 78-87) at age 15 years and 70% (61-80) at 30 years. The type of variant was predictive of outcome: patients with a missense variant in exons 1 or 2 or with the intronic hot spot variant c.559+5G>A (class I variants) had a 15-year OS of 93% (89-98) and a 30-year OS of 91% (86-97), compared with 71% (62-81) and 48% (34-68) in patients with any other variant (class II; P < .0001). The cumulative incidence rates of disease-related complications such as severe bleeding (P = .007), life-threatening infection (P < .0001), and autoimmunity (P = .004) occurred significantly later in patients with a class I variant. The cumulative incidence of malignancy (P = .6) was not different between classes I and II. It confirms the spectrum of disease severity and quantifies the risk for specific disease-related complications. The class of the variant is a biomarker to predict the outcome for patients with WAS.

Allergy and Immunology Division Pediatrics Department Universidade Federal de Uberlândia Uberlândia Brazil

Azerbaijan Medical University Baku Azerbaijan

Bone Marrow Transplantation Department Hadassah Hebrew University Medical Center Jerusalem Israel

Centre de référence des déficits immunitaires primitifs CEREDIH CHU d'Angers Angers France

Children's Hospital School of Medicine Technical University Munich Munich Germany

Children's Hospital University of Helsinki and Helsinki University Hospital Pediatric Research Center Helsinki Finland

Clinical Immunology John Radcliffe Hospital Oxford United Kingdom

Department for Children and Adolescents Pediatric Hematopoietic Stem Cell Transplantation and Immunodeficiency Copenhagen University Hospital Rigshospitalet København Denmark

Department of Allergy and Immunology The Royal Children's Hospital Melbourne Australia

Department of Child Health and Development Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan

Department of Haematology Oncology Anna Meyer University Children's Hospital Florence Italy

Department of Hematology Children's Hospital of Orange County Orange CA

Department of Immunology Children's Memorial Health Institute Warsaw Poland

Department of Immunology Mother and Child Health Care Institute of Serbia Belgrade Serbia

Department of Infection Immunity and Inflammation University of Leicester Leicester United Kingdom

Department of NEUROFARBA Section of Child's Health University of Florence Florence Italy

Department of Paediatrics Haematology and Oncology Collegium Medicum in Bydgoszcz Nicolaus Copernicus University Toruń Poland

Department of Pediatric Hematology and Oncology Charles University and University Hospital Motol Prague Czech Republic

Department of Pediatric Hematology Oncology Koç University School of Medicine İstanbul Turkey

Department of Pediatric Immunology and Infectious Diseases University Medical Centre Utrecht Utrecht The Netherlands

Department of Pediatric Oncology and Hematology Institute of Pediatrics Jagiellonian University Medical College Krakow Poland

Department of Pediatrics and Adolescent Medicine Oulu University Hospital and Research Unit of Clinical Medicine University of Oulu Oulu Finland

Department of Pediatrics Faculty of Medicine Comenius University Bratislava Slovakia

Department of Pediatrics Fondazione IRCCS San Gerardo dei Tintori Monza Italy

Department of Pediatrics Immunology Infectious and Rare Diseases and Allergology European Medical School International European University Kyiv Ukraine

Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Department of Pediatrics Kuopio University Hospital Kuopio Finland

Department of Pediatrics Pediatric Infectious Diseases Immunology and Allergology Shupyk National Healthcare University of Ukraine Kyiv Ukraine

Department of Pediatrics Primary Immunodeficiencies Unit Research Institute Hospital 12 Octubre School of Medicine Complutense University of Madrid Madrid Spain

Department of Pediatrics The University of Alabama at Birmingham Birmingham AL

Department of Pediatrics University Hospitals Leuven Leuven Belgium

Department of Pediatrics University Medical Center Ulm Ulm Germany

Department of Rheumatism and Immunology Children's Hospital of Chongqing Medical University Chongqing China

Department of Translational Medical Science Section of Pediatrics Federico 2 University Napoli Italy

Division of Pediatric Hematology and Oncology Department of Pediatrics Turku University Hospital Turku Finland

Division of Pediatric Immunology Department of Pediatrics Ege University The Medical School Izmir Turkey

Dmitry Rogachev National Research and Clinical Center of Pediatric Hematology Oncology and Immunology Moscow Russia

Helios Kliniken Krefeld Children's Hospital Krefeld Germany

Hematologic Malignancies Branch Office of Therapeutic Products Center for Biologics Evaluation and Research Food and Drug Administration Silver Spring MD

Lydia Becker Institute of Immunology and Inflammation The University of Manchester and Royal Manchester Children's Hospital Manchester United Kingdom

Medical Direction Children's Hospital ASST Spedali Civili Brescia Italy

Pediatric Hematology Oncology Dr von Hauner University Children's Hospital Munich Germany

Pediatric Immunohematology and Stem Cell Program San Raffaele Telethon Institute for Gene Therapy IRCCS San Raffaele Scientific Institute Milan Italy

Pediatric Immunology and Rheumatology Bursa Uludag University School of Medicine Bursa Turkey

Pediatric Infectious Diseases and Immunodeficiencies Unit Children's Hospital Vall d'Hebron Barcelona Hospital Campus Barcelona Spain

Russian Children's Clinical Hospital Pirogov National Research Medical University Moscow Russia

School of Medicine and Surgery University of Milano Bicocca Milan Italy

School of Women's and Children's Health University of New South Wales Sydney Australia

St James's Hospital and School of Medicine Trinity College Dublin Ireland

Staburo GmbH Munich Germany

Translational and Clinical Research Institute Newcastle University and Paediatric Stem Cell Transplant Unit Great North Children's Hospital Newcastle upon Tyne United Kingdom

University of Washington School of Medicine Seattle WA

Vita Salute San Raffaele University Milan Italy

Citace poskytuje Crossref.org

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