PMC Hereditary Leukemia and Myelodysplastic Syndrome Panel

Up to 49 genes Turn around Time: 10 business days
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Test Description

PMC Hereditary Myelodysplastic Syndrome/Leukemia Panel examines genes linked to a hereditary predisposition to hematologic cancers| including myelodysplasia and acute leukemia. Due to the genetic diversity associated with these cancers| relying solely on phenotype can be challenging in determining the underlying cause. With many genes overlapping in leukemia susceptibility| a comprehensive panel test can efficiently evaluate multiple potential genes for individuals with similar clinical symptoms. This test focuses on heritable germline mutations and is not designed for detecting somatic mutations.

  • Associated Conditions
    • Acute myeloid leukemia
    • Acute myeloid leukemia, familial
    • Adrenocortical carcinoma
    • Aplastic anemia
    • Ataxia-pancytopenia syndrome
    • Ataxia-telangiectasia
    • Bloom syndrome
  • Methodology

    Targeted Exome/ Slice Exome (Next Generation Sequencing including Copy Number Variation)

  • Assay Information
    • BRCA1: Sequence analysis includes +/- 20 base pairs of adjacent intronic sequence.
    • BRCA2: Sequence analysis includes +/- 20 base pairs of adjacent intronic sequence.
    • MLH1: Deletion/duplication analysis covers the promoter region. Sequencing analysis for exons 12 includes only cds +/- 10 bp.
    • MSH6: Sequencing analysis for exons 7| 10 includes only cds +/- 10 bp.
    • TP53: Deletion/duplication analysis covers the promoter region.
    • ATM: Sequencing analysis for exons 6| 24| 43 includes only cds +/- 10 bp.
    • MSH2: Analysis includes the exon 1-7 inversion (Boland mutation). Sequencing analysis for exons 2| 5 includes only cds +/- 10 bp. Deletions restricted to only the EPCAM gene will not be detected unless EPCAM analysis is requested.
  • Limitations

    All sequencing technologies have limitations. A negative result from this analysis does not rule out a possible genetic diagnosis as some variants may not be detected by this test. This test is not designed to detect low level mosaicism, structural rearrangements, indels >40bp, deep intronic variants of unknown clinical significance, or large cytogenetic CNVs. Certain inherent qualities of the human genome, for example repetitive regions/homopolymers, GC rich, pseudogenes, and rare polymorphisms, pose significant technical challenges such as sequence misalignment that may potentially impact the accuracy of the results. False negative results may also occur in the setting of allogeneic bone marrow, stem cell transplantation, active or chronic hematologic conditions, recent blood transfusions, suboptimal DNA quality or PCR trace contamination. Other potential sources of error include sample mix-ups and clerical issues.

  • References
    • 1. Richards S et al. Genetics in medicine. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. 2015 May;17(5):405-24 (PMID: 25741868)
    • 2. GnomAD (gnomAD)
    • 3. CSPEC (ClinGen variant classification rules registry) Criteria Specification Registry
    • 4. Normal copy number variation in healthy individuals database of genomic variants: http://dgv.tcag.ca/dgv/app/home
  • Tagged Genes

    Primary panel:

    49 genes selected