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. 2021 Dec 10;42(2):404–420. doi: 10.1007/s10875-021-01189-y

Table 1.

Clinical characteristics and outcome in patients with GATA2 deficiency

Patient no Family Sex Current
age
Age at onset of symptoms/age at genetic diagnosis Infections Hearing loss Hematologic abnormalities Autoimmunity/immune dysregulation Miscellaneous HSCT, age Outcome
Viral Bacterial
1 A (father of P2 and P3) M 44y 5y/41y

HPV: warts

HSV: disseminated disease

Ear infections as a child Yes Hypoplastic BM: cytopenia, trilinear hypoplasia No No 41y Alive
2 A (son of P1) M 16y 7y/14y HPV: warts No No MDS-EB-1 No No 16y Alive
3 A (daughter of P1) F 13y 8y/9y HPV: warts No No No No No ND Alive
4a B (monozygotic twin to P5) F 45y 21y/38y

HPV: warts, carcinoma in situ

EBV: prolonged viremia

Recurrent respiratory inf

Suppurative skin infection after BCG *

Yes No Progressive obliterating bronchiolitis, lupus-like syndrome Miscarriage 39y Alive
5a B (monozygotic twin to P4) F † (39y) 24y/38y

HPV: warts, carcinoma

VZV and EBV: prolonged viremia

Recurrent respiratory inf

Suppurative skin inf. after BCG*

Yes MDS-MLD (hypoplastic) Progressive obliterating bronchiolitis, lupus-like syndrome

DVT × 2

Squamous cell carcinoma in the cervix, rectum, and anus

39y Deceased 8 m post-HSCTb
6a C M 31y 11y/26y No Recurrent respiratory inf Yes MDS-MLD (hypoplastic) - Fever of unknown origin, recurrent pneumothorax 29y Alive
7a D F 23y 6y/17y HPV: warts Recurrent respiratory inf No MDS-MLD (hypoplastic) Interstitial lung disease Lymphedema, acne, rosacea, rash, fatigue 22y Alive
8 E F 56y 0y/53y No No No Hypoplastic BM No Lymphedema, premature graying ND Alive
9 F F 24y 15y/23y No No No AML with MDS-related changes Erythema nodosum DVT, PE, juvenile myoclonic epilepsy, epicanthic fold 23y Alive
10 G (sibling to P11) F 32y 6y/31y HPV: warts, cervix dysplasia Recurrent respiratory inf Yes MDS-MLD No Aneurysm of small vessels, hidradenitis suppurative, liver lesions: focal nodular hyperplasia 32y Alive
11 G (sibling to P10) M † (34y) 22y/PM No Recurrent skin and respiratory inf No MDS-MLD No Acne, rosacea, necrotizing fasciitis, pilonidal cysts, skin infections, ulcerations 27y Deceased 7y post-HSCTc
12 H F 19y 14y/14y No No Yesd MDS-RCC (hypoplastic) BPD/Asthma Born premature (week 26 + 5), BPD 14y Alive
13 I M 13y 9y/11 y HPV: warts No No MDS-EB1 Asthma Chronic skin abscesses, congenital ptosis 11y Alive
14 J F 31 23y/31y No No Yes MDS-SLD (hypoplastic) No Born prematurely (week 25), cerebral palsy, congenital hip dysplasia Planned Alive

Abbreviations: AML, acute myeloid leukemia; BCG, bacille Calmette Geurin; BM, bone marrow; BPD, bronchopulmonary dysplasia, CT, computer tomography, HPV, human papilloma virus; HSCT, hematopoietic stem cell transplantation; Inf., infection; m, months; MDS, myelodysplastic syndrome; MDS-EB1, MDS with excess of blasts type 1; MDS-MLD, MDS with multilineage dysplasia; MDS-SLD, MDS with single lineage dysplasia; MDS-RCC, MDS subtype refractory cytopenia of childhood; ND, not done, PM, post mortem; VTE, venous thromboembolism; y, years, †; deceased

aThese patients have previously been published in Stray-Pedersen, Sorte et al. 2016 (Patient 4 was 84.1, Patient 5 was 84.4, Patient 6 was 88.1, and Patient 7 was 86.1)[21]

bThe patient was doing well after HSCT, but died unexpectedly of a cerebral hemorrhage

cThe patient underwent lung transplantation for chronic lung GVHD 58 months after HSCT, and died of chronic lung rejection 26 months after bilateral lung transplantation

dThe patient has reduced hearing, but this was confirmed after HSCT. Her hearing loss may be due to the disease-causing GATA2 variant, but may also be secondary to complications of HSCT therapy, e.g., aminoglycosides