Affiliation:
1. Harold C. Simmons Comprehensive Cancer Center University of Texas Southwestern Medical Center Dallas Texas USA
2. Department of Internal Medicine, Division of Hematology and Medical Oncology, Leukemia Program UT Southwestern Medical Center Dallas Texas USA
3. Department of Pathology University of Texas Southwestern Medical Center Dallas Texas USA
Abstract
AbstractIntroductionFour to 10% of cases of myeloid malignancies are inherited. We report our experience on hereditary myeloid malignancy syndromes (HMMS) incorporating a novel questionnaire in the screening platform for patients with myeloid malignancies and aplastic anemia.MethodsThe questionnaire was sent via electronic patient portal prior to clinic visits. Patients screened positive based on responses to questionnaire items, presence of suspicion disease characteristics (young age, family history, monosomy 7 etc.) and/or presence of signs of HMMS. Those deemed at‐risk based on questionnaire responses, clinical features and/or somatic mutation profile were offered germline testing.ResultsA total of 408 patients were screened, 141 (35%) were deemed at‐risk. Fifty‐four (38%) of at‐risk patients were seen in the genetics clinic. Forty‐one (76%) of the patients seen agreed to germline testing and 13 declined due to cost or personal decision. Twenty pathogenic (P)/likely‐pathogenic (LP) germline mutations were identified in 16 (39%) of the tested patients. Five patients also had a variant of uncertain significance (VUS) and an additional 13 had at least 1 VUS without P/LP mutations (total 29 VUS's were found in 18 (44%) of tested patients). The median age of diagnosis for patients with P/LP mutations was 56 years versus 66 years in the entire cohort.ConclusionIncorporating an electronic questionnaire is an effective screening method for HMMS. Many patients declined testing due to cost. These results highlight the importance of germline testing in patients with myeloid malignancies, further research in HMMS, and coverage by healthcare plans.
Subject
Hematology,General Medicine