Clinical features of dyskeratosis congenita in mainland China: case reports and literature review

Int J Hematol. 2019 Mar;109(3):328-335. doi: 10.1007/s12185-018-02582-x. Epub 2019 Jan 3.

Abstract

Dyskeratosis congenita (DC) is a rare-inherited bone marrow failure syndrome associated with multi-system disorder. To summarize the clinical features, epidemiology, and treatment of DC in mainland China, we retrospectively reviewed the medical records of two patients diagnosed with DC at our hospital and published reports on other DC patients in mainland China. The clinical features of 82 DC patients were summarized. The median age of onset was 5 years, but the median age at diagnosis was 16 years. Bone marrow failure occurred at a high rate of 44% and early, with a median onset age of 6 years (range 1-40 years). Only DKC1, TINF2, and TERT mutations were reported, which is a relatively simple signature. Aplastic anemia was treated mainly with low-dose androgens, glucocorticoids, or allogeneic hematopoietic stem cell transplantation, with an efficacy of 39% (14/36). In China, DC is relatively common in infants, with early age of onset but delayed diagnosis. Bone marrow failure occurred at a high rate and early. Improvement in the knowledge and awareness of DC combined with gene mutation tests will facilitate diagnosis and therapy in its early stages.

Keywords: Aplastic anemia; Bone marrow failure syndrome; China; Clinical feature; Dyskeratosis congenita.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Age of Onset
  • Allografts
  • Androgens / therapeutic use*
  • Anemia, Aplastic* / diagnosis
  • Anemia, Aplastic* / epidemiology
  • Anemia, Aplastic* / genetics
  • Anemia, Aplastic* / therapy
  • Cell Cycle Proteins / genetics
  • Child
  • Child, Preschool
  • China
  • Dyskeratosis Congenita* / diagnosis
  • Dyskeratosis Congenita* / epidemiology
  • Dyskeratosis Congenita* / genetics
  • Dyskeratosis Congenita* / therapy
  • Female
  • Glucocorticoids / therapeutic use*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Mutation*
  • Nuclear Proteins / genetics
  • Telomerase / genetics
  • Telomere-Binding Proteins / genetics

Substances

  • Androgens
  • Cell Cycle Proteins
  • DKC1 protein, human
  • Glucocorticoids
  • Nuclear Proteins
  • TINF2 protein, human
  • Telomere-Binding Proteins
  • TERT protein, human
  • Telomerase