Table 1.
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