Skip to main content
Top
Published in: Indian Journal of Pediatrics 7/2011

01-07-2011 | Original Article

Transient Myeloproliferative Disorder and GATA1 Mutation in Neonates With and Without Down Syndrome

Authors: Ming-Horng Tsai, Jia-Woei Hou, Chao-Ping Yang, Pong-Hong Yang, Shih-Ming Chu, Jen-Fu Hsu, Ming-Chou Chiang, Hsuan-Rong Huang

Published in: Indian Journal of Pediatrics | Issue 7/2011

Login to get access

Abstract

Objective

To report clinical experiences and cytogenetic findings of transient myeloproliferative disorder (TMD) in neonates with and without Down syndrome (DS).

Methods

GATA1 gene was screened in DNA samples from neonates presenting with TMD during their leukemic and remission status.

Results

Six neonates (2 phenotypically normal and 4 DS) born in the past 6 years had presented with TMD; all had trisomy 21 during leukemic status. Two DS infants died during early infancy, one of hepatic failure and one of cardiac complication. One non-DS infant evolved into myelodysplastic syndrome (MDS) and acute leukemia since 14 months old. Three other patients have not developed true leukemia after follow-up of 8, 9, and 70 months, respectively. The authors detected mutations within exon 2 of GATA1 gene in 3 DS and 2 non-DS infants. All these mutations disappeared after remission of TMD, but an identical mutation was detected in one non-DS patient when evolving into MDS. Trisomy 21 was confined to leukemic clone in non-DS patients.

Conclusions

TMD should be considered in case of congenital leukemia with megakaryoblastic features and accompanied by trisomy 21 and GATA1 mutation. Both DS and non-DS patients will possibly develop true leukemia within few years.
Literature
1.
go back to reference Massey GV. Transient leukemia in newborns with Down syndrome. Pediatr Blood Cancer. 2005;44:29–32.PubMedCrossRef Massey GV. Transient leukemia in newborns with Down syndrome. Pediatr Blood Cancer. 2005;44:29–32.PubMedCrossRef
2.
go back to reference Schunk GJ, Lehman WL. Mongolism and congenital leukemia. JAMA. 1954;155:250–1. Schunk GJ, Lehman WL. Mongolism and congenital leukemia. JAMA. 1954;155:250–1.
3.
go back to reference Engel R, Hammond D. Transient congenital leukemia in 7 infants with mongolism. J Pediatr. 1964;65:303–5.PubMedCrossRef Engel R, Hammond D. Transient congenital leukemia in 7 infants with mongolism. J Pediatr. 1964;65:303–5.PubMedCrossRef
4.
go back to reference Magalhães IQ, Splendore A, Emerenciano M, et al. Transient neonatal myeloproliferative disorder without Down syndrome and detection of GATA1 mutation. J Pediatr Hematol Oncol. 2005;27:50–2.PubMedCrossRef Magalhães IQ, Splendore A, Emerenciano M, et al. Transient neonatal myeloproliferative disorder without Down syndrome and detection of GATA1 mutation. J Pediatr Hematol Oncol. 2005;27:50–2.PubMedCrossRef
5.
go back to reference Cushing T, Clericuzio CL, Wilson CS, et al. Risk for leukemia in infants without Down syndrome who have transient myeloproliferative disorder. J Pediatr. 2006;148:687–9.PubMedCrossRef Cushing T, Clericuzio CL, Wilson CS, et al. Risk for leukemia in infants without Down syndrome who have transient myeloproliferative disorder. J Pediatr. 2006;148:687–9.PubMedCrossRef
6.
go back to reference Brissette MD, Duval-Arnould BJ, Gordon BG, Cotelingam JD. Acute megakaryoblastic leukemia following transient myeloproliferative disorder in a patient without Down syndrome. Am J Hematol. 1994;47:316–9.PubMedCrossRef Brissette MD, Duval-Arnould BJ, Gordon BG, Cotelingam JD. Acute megakaryoblastic leukemia following transient myeloproliferative disorder in a patient without Down syndrome. Am J Hematol. 1994;47:316–9.PubMedCrossRef
7.
go back to reference Richards M, Welch J, Watmore A, Readett D, Vora AJ. Trisomy 21 associated transient neonatal myeloproliferation in the absence of Down’s syndrome. Arch Dis Child Fetal Neonatal Ed. 1998;79:F215–217.PubMedCrossRef Richards M, Welch J, Watmore A, Readett D, Vora AJ. Trisomy 21 associated transient neonatal myeloproliferation in the absence of Down’s syndrome. Arch Dis Child Fetal Neonatal Ed. 1998;79:F215–217.PubMedCrossRef
8.
go back to reference Crispino JD. GATA1 mutations in Down syndrome: implications for biology and diagnosis of children with transient myeloproliferative disorder and acute megakaryoblastic leukemia. Pediatr Blood Cancer. 2005;44:40–4.PubMedCrossRef Crispino JD. GATA1 mutations in Down syndrome: implications for biology and diagnosis of children with transient myeloproliferative disorder and acute megakaryoblastic leukemia. Pediatr Blood Cancer. 2005;44:40–4.PubMedCrossRef
9.
go back to reference Gassas A, Doyle JJ, Weitzman S, et al. A basic classification and a comprehensive pediatric myeloproliferative disorder. J Pediatr Hematol Oncol. 2005;27:192–6.PubMedCrossRef Gassas A, Doyle JJ, Weitzman S, et al. A basic classification and a comprehensive pediatric myeloproliferative disorder. J Pediatr Hematol Oncol. 2005;27:192–6.PubMedCrossRef
10.
go back to reference Massey GV, Zipursky A, Chang MN, et al. A prospective study of the natural history of transient leukemia (TL) in neonates with Down syndrome (DS): a Children’s Oncology Group (COG) study POG-9481. Blood. 2006;107:4606–13.PubMedCrossRef Massey GV, Zipursky A, Chang MN, et al. A prospective study of the natural history of transient leukemia (TL) in neonates with Down syndrome (DS): a Children’s Oncology Group (COG) study POG-9481. Blood. 2006;107:4606–13.PubMedCrossRef
11.
go back to reference Vyas P, Crispino JD. Molecular insights into Down syndrome-associated leukemia. Curr Opin Pediatr. 2007;19:9–14.PubMedCrossRef Vyas P, Crispino JD. Molecular insights into Down syndrome-associated leukemia. Curr Opin Pediatr. 2007;19:9–14.PubMedCrossRef
12.
go back to reference Greene ME, Mundschau G, Wechsler J, et al. Mutations in GATA1 in both transient myeloproliferative disorder and acute megakaryoblastic leukemia of Down syndrome. Blood Cells Mol Dis. 2003;31:351–6.PubMedCrossRef Greene ME, Mundschau G, Wechsler J, et al. Mutations in GATA1 in both transient myeloproliferative disorder and acute megakaryoblastic leukemia of Down syndrome. Blood Cells Mol Dis. 2003;31:351–6.PubMedCrossRef
13.
go back to reference Ahmed M, Sternberg A, Hall G, et al. Natural history of GATA1 mutations in Down syndrome. Blood. 2004;103:2480–9.PubMedCrossRef Ahmed M, Sternberg A, Hall G, et al. Natural history of GATA1 mutations in Down syndrome. Blood. 2004;103:2480–9.PubMedCrossRef
14.
go back to reference Zipursky A, Brown EJ, Christensen H, Doyle J. Transient myeloproliferative disorder (transient leukemia) and hematologic manifestations of Down syndrome. Clin Lab Med. 1999;19:157–67.PubMed Zipursky A, Brown EJ, Christensen H, Doyle J. Transient myeloproliferative disorder (transient leukemia) and hematologic manifestations of Down syndrome. Clin Lab Med. 1999;19:157–67.PubMed
15.
go back to reference Hasle H, Clemmensen IH, Mikkelsen M. Risks of leukemia and solid tumors in individuals with Down’s syndrome. Lancet. 2000;355:165–9.PubMedCrossRef Hasle H, Clemmensen IH, Mikkelsen M. Risks of leukemia and solid tumors in individuals with Down’s syndrome. Lancet. 2000;355:165–9.PubMedCrossRef
16.
go back to reference Massey GV. Transient leukemia in newborns with Down syndrome. Pediatr Blood Cancer. 2005;44:29–32.PubMedCrossRef Massey GV. Transient leukemia in newborns with Down syndrome. Pediatr Blood Cancer. 2005;44:29–32.PubMedCrossRef
17.
go back to reference Brink DS. Transient leukemia (transient myeloproliferative disorder, transient abnormal myelopoiesis) of Down syndrome. Adv Anat Pathol. 2006;13:256–62.PubMedCrossRef Brink DS. Transient leukemia (transient myeloproliferative disorder, transient abnormal myelopoiesis) of Down syndrome. Adv Anat Pathol. 2006;13:256–62.PubMedCrossRef
18.
go back to reference Zipursky A, Brown E, Christensen H, Sutherland R, Doyle J. Leukemia and/or myeloproliferative syndrome in neonates with Down syndrome. Semin Perinatol. 1997;21:97–101.PubMedCrossRef Zipursky A, Brown E, Christensen H, Sutherland R, Doyle J. Leukemia and/or myeloproliferative syndrome in neonates with Down syndrome. Semin Perinatol. 1997;21:97–101.PubMedCrossRef
19.
go back to reference Adam M, Vincenot A, Gouraud F, et al. Transient myeloproliferative disorder in a neonate without Down syndrome. Ann Biol Clin (Paris). 2007;65:569–73. Adam M, Vincenot A, Gouraud F, et al. Transient myeloproliferative disorder in a neonate without Down syndrome. Ann Biol Clin (Paris). 2007;65:569–73.
20.
go back to reference Wechsler J, Greene M, McDevitt MA, et al. Acquired mutations in GATA1 in the megakaryoblastic leukemia of Down syndrome. Nat Genet. 2002;32:148–52.PubMedCrossRef Wechsler J, Greene M, McDevitt MA, et al. Acquired mutations in GATA1 in the megakaryoblastic leukemia of Down syndrome. Nat Genet. 2002;32:148–52.PubMedCrossRef
21.
go back to reference Li Z, Godinho FJ, Klusmann JH, Garriga-Canut M, Yu C, Orkin SH. Developmental stage selective effect of somatically mutated leukemogenic transcription factor GATA1. Nat Genet. 2005;37:613–9.PubMedCrossRef Li Z, Godinho FJ, Klusmann JH, Garriga-Canut M, Yu C, Orkin SH. Developmental stage selective effect of somatically mutated leukemogenic transcription factor GATA1. Nat Genet. 2005;37:613–9.PubMedCrossRef
22.
go back to reference Muntean AG, Crispino JD. Differential requirements for the activation domain and FOG-interaction surface of GATA-1 in megakaryocyte gene expression and development. Blood. 2005;106:1223–31.PubMedCrossRef Muntean AG, Crispino JD. Differential requirements for the activation domain and FOG-interaction surface of GATA-1 in megakaryocyte gene expression and development. Blood. 2005;106:1223–31.PubMedCrossRef
23.
go back to reference Carpenter E, Valverde-Garduno V, Sternberg A, Mitchell C, Roberts I, Vyas R. GATA1 mutation and trisomy 21 are required only in haematopoietic cells for development of transient myeloproliferative disorder. Br J Haematol. 2005;128:548–51.PubMedCrossRef Carpenter E, Valverde-Garduno V, Sternberg A, Mitchell C, Roberts I, Vyas R. GATA1 mutation and trisomy 21 are required only in haematopoietic cells for development of transient myeloproliferative disorder. Br J Haematol. 2005;128:548–51.PubMedCrossRef
24.
go back to reference Gurbuxani S, Vyas P, Crispino JD. Recent insights into the mechanisms of myeloid leukemogenesis in Down syndrome. Blood. 2004;103:399–406.PubMedCrossRef Gurbuxani S, Vyas P, Crispino JD. Recent insights into the mechanisms of myeloid leukemogenesis in Down syndrome. Blood. 2004;103:399–406.PubMedCrossRef
25.
go back to reference Xu G, Kato K, Toki T, Yoshihiro T, Kiminori T, Ito E. Development of acute megakaryoblastic leukemia from a minor clone in a Down syndrome patient with clinically overt transient myeloproliferative disorder. J Pediatr Hematol Oncol. 2006;28:696–8.PubMedCrossRef Xu G, Kato K, Toki T, Yoshihiro T, Kiminori T, Ito E. Development of acute megakaryoblastic leukemia from a minor clone in a Down syndrome patient with clinically overt transient myeloproliferative disorder. J Pediatr Hematol Oncol. 2006;28:696–8.PubMedCrossRef
26.
go back to reference Chou ST, Opalinska JB, Yao Y, et al. Trisomy 21 enhances human fetal erythro-megakaryocytic development. Blood. 2008;112:4503–6.PubMedCrossRef Chou ST, Opalinska JB, Yao Y, et al. Trisomy 21 enhances human fetal erythro-megakaryocytic development. Blood. 2008;112:4503–6.PubMedCrossRef
27.
go back to reference Stark B, Jeison M, Preudhomme C, et al. Acquired trisomy 21 and distinct clonal evolution in acute megakaryoblastic leukaemia in young monozygotic twins. Br J Haematol. 2002;118:1082–6.PubMedCrossRef Stark B, Jeison M, Preudhomme C, et al. Acquired trisomy 21 and distinct clonal evolution in acute megakaryoblastic leukaemia in young monozygotic twins. Br J Haematol. 2002;118:1082–6.PubMedCrossRef
28.
go back to reference Rainis L, Bercovich D, Strehl S, et al. Mutations in exon 2 of GATA1 are early events in megakaryocytic malignancies associated with trisomy 21. Blood. 2003;102:981–6.PubMedCrossRef Rainis L, Bercovich D, Strehl S, et al. Mutations in exon 2 of GATA1 are early events in megakaryocytic malignancies associated with trisomy 21. Blood. 2003;102:981–6.PubMedCrossRef
29.
go back to reference Pine SR, Guo Q, Yin C, Jayabose S, Druschel CM, Sandoval C. Incidence and clinical implications of GATA1 mutations in newborns with Down syndrome. Blood. 2007;110:2128–31.PubMedCrossRef Pine SR, Guo Q, Yin C, Jayabose S, Druschel CM, Sandoval C. Incidence and clinical implications of GATA1 mutations in newborns with Down syndrome. Blood. 2007;110:2128–31.PubMedCrossRef
30.
go back to reference Shin MG, Choi HW, Kim HR, et al. Tetrasomy 21 as a sole acquired abnormality without GATA1 gene mutation in pediatric acute megakaryoblastic leukemia: a case report and review of the literature. Leuk Res. 2008;32:1615–9.PubMedCrossRef Shin MG, Choi HW, Kim HR, et al. Tetrasomy 21 as a sole acquired abnormality without GATA1 gene mutation in pediatric acute megakaryoblastic leukemia: a case report and review of the literature. Leuk Res. 2008;32:1615–9.PubMedCrossRef
Metadata
Title
Transient Myeloproliferative Disorder and GATA1 Mutation in Neonates With and Without Down Syndrome
Authors
Ming-Horng Tsai
Jia-Woei Hou
Chao-Ping Yang
Pong-Hong Yang
Shih-Ming Chu
Jen-Fu Hsu
Ming-Chou Chiang
Hsuan-Rong Huang
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Indian Journal of Pediatrics / Issue 7/2011
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-010-0312-x

Other articles of this Issue 7/2011

Indian Journal of Pediatrics 7/2011 Go to the issue

Scientific Letters to the Editor

Accidental Endosulfan Ingestion in a Toddler