Non-invasive prenatal diagnostic testing for β-thalassaemia using cell-free fetal DNA and next generation sequencing

Prenat Diagn. 2015 Mar;35(3):258-65. doi: 10.1002/pd.4536. Epub 2014 Dec 29.

Abstract

Objective: To develop an accurate non-invasive prenatal test using next generation sequencing (NGS) for HbE and the four most common β-thalassaemia mutations found in South East Asia (namely -28A > G, CD17A > T, CD41/42(-TTCT) and IVS-II-654C > T).

Methods: Cell-free DNA was extracted from maternal plasma from 83 families where both parents were carriers of the HbE mutation or one of four common β-thalassaemia mutations. Overlapping PCR amplicons covering each mutation were generated, pooled and sequenced using the Illumina MiSeq. Fastq files were analysed to detect inheritance of the paternal mutation.

Results: In two cases where the fathers were compound heterozygotes for HbE and -28A > G, the fetus was correctly diagnosed as having inherited one of the paternal mutations. In 35/85 cases, the paternal mutation was not detected, and in 50/85 cases, it was classified as inherited. Overall sensitivity for detection of paternal mutations was 100% (95% CI: 92.4-100%), and specificity was 92.1% (95% CI: 79.2-97.3%).

Conclusion: We demonstrated that detection of paternal mutations using NGS can be readily achieved with high sensitivity and specificity, removing the need for an invasive test in 50% of pregnancies at risk of a thalassaemia in cases where the father and mother carry a different mutation. © 2014 John Wiley & Sons, Ltd.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • DNA / blood
  • DNA / genetics*
  • Female
  • Fetus / metabolism*
  • Genotype
  • Hemoglobin E / genetics*
  • Hemoglobins, Abnormal / genetics
  • Heterozygote
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Male
  • Mutation
  • Polymerase Chain Reaction
  • Pregnancy
  • Prenatal Diagnosis / methods
  • Sensitivity and Specificity
  • Sequence Analysis, DNA
  • beta-Thalassemia / diagnosis
  • beta-Thalassemia / genetics*

Substances

  • Hemoglobins, Abnormal
  • DNA
  • Hemoglobin E