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Hoover A, Turcotte LM, Phelan R, Barbus C, Rayannavar A, Miller BS, Reardon EE, Theis-Mahon N, MacMillan ML. Longitudinal clinical manifestations of Fanconi anemia: A systematized review. Blood Rev 2024; 68:101225. [PMID: 39107201 PMCID: PMC11568946 DOI: 10.1016/j.blre.2024.101225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/09/2024]
Abstract
Fanconi anemia (FA) is a rare and complex inherited genetic disorder characterized by impaired DNA repair mechanisms leading to genomic instability. Individuals with FA have increased susceptibility to congenital anomalies, progressive bone marrow failure, leukemia and malignant tumors, endocrinopathies and other medical issues. In recent decades, steadily improved approaches to hematopoietic cell transplantation (HCT), the only proven curative therapy for the hematologic manifestations of FA, have significantly increased the life expectancy of affected individuals, illuminating the need to understand the long-term consequences and multi-organ ramifications. Utilizing a systematized review approach with narrative synthesis of each primary issue and organ system, we shed light on the challenges and opportunities for optimizing the care and quality of life for individuals with FA and identify knowledge gaps informing future research directions.
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Affiliation(s)
- Alex Hoover
- Division of Blood and Marrow Transplantation & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
| | - Lucie M Turcotte
- Division of Hematology and Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Rachel Phelan
- Division of Hematology, Oncology, and Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Crystal Barbus
- Division of Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Arpana Rayannavar
- Division of Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Bradley S Miller
- Division of Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Erin E Reardon
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA
| | | | - Margaret L MacMillan
- Division of Blood and Marrow Transplantation & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Sauter SL, Zhang X, Romick-Rosendale L, Wells SI, Myers KC, Brusadelli MG, Poff CB, Brown DR, Panicker G, Unger ER, Mehta PA, Bleesing J, Davies SM, Butsch Kovacic M. Human Papillomavirus Oral- and Sero- Positivity in Fanconi Anemia. Cancers (Basel) 2021; 13:cancers13061368. [PMID: 33803570 PMCID: PMC8003090 DOI: 10.3390/cancers13061368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary People with Fanconi anemia (FA) are genetically susceptible to gynecological cancers and cancers of the head and neck. There are known associations between oral infection with human papillomavirus (HPV) and development of head and neck cancers. This study sought to measure how common oral HPV positivity is in a large sample of people with FA followed over 8 years, while also evaluating serum titers to ascertain natural exposure to HPV, and how well people with FA who were vaccinated responded to HPV vaccination. We found that oral HPV positivity is significantly higher in individuals with FA compared to family and unrelated controls, but that response to HPV vaccination between FA and controls is similar. Common risk factors associated with HPV in the general population did not predict oral DNA positivity in FA, unlike unrelated controls. Future mechanistic and vaccinations studies are needed to understand this phenomenon. Abstract High-risk human papillomavirus (HPV) is prevalent and known to cause 5% of all cancers worldwide. The rare, cancer prone Fanconi anemia (FA) population is characterized by a predisposition to both head and neck squamous cell carcinomas and gynecological cancers, but the role of HPV in these cancers remains unclear. Prompted by a patient-family advocacy organization, oral HPV and HPV serological studies were simultaneously undertaken. Oral DNA samples from 201 individuals with FA, 303 unaffected family members, and 107 unrelated controls were tested for 37 HPV types. Serum samples from 115 individuals with FA and 55 unrelated controls were tested for antibodies against 9 HPV types. Oral HPV prevalence was higher for individuals with FA (20%) versus their parents (13%; p = 0.07), siblings (8%, p = 0.01), and unrelated controls (6%, p ≤ 0.001). A FA diagnosis increased HPV positivity 4.84-fold (95% CI: 1.96–11.93) in adjusted models compared to unrelated controls. Common risk factors associated with HPV in the general population did not predict oral positivity in FA, unlike unrelated controls. Seropositivity and anti-HPV titers did not significantly differ in FA versus unrelated controls regardless of HPV vaccination status. We conclude that individuals with FA are uniquely susceptible to oral HPV independent of conventional risk factors.
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Affiliation(s)
- Sharon L. Sauter
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Xue Zhang
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Lindsey Romick-Rosendale
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Susanne I. Wells
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Kasiani C. Myers
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Marion G. Brusadelli
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Charles B. Poff
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Darron R. Brown
- Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Gitika Panicker
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (G.P.); (E.R.U.)
| | - Elizabeth R. Unger
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (G.P.); (E.R.U.)
| | - Parinda A. Mehta
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Jack Bleesing
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Stella M. Davies
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
| | - Melinda Butsch Kovacic
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (S.L.S.); (X.Z.); (L.R.-R.); (S.I.W.); (K.C.M.); (M.G.B.); (C.B.P.); (P.A.M.); (J.B.); (S.M.D.)
- Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati College of Allied Health Sciences, Cincinnati, OH 45267, USA
- Correspondence:
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Amenábar JM, Torres‐Pereira CC, Tang KD, Punyadeera C. Two enemies, one fight: An update of oral cancer in patients with Fanconi anemia. Cancer 2019; 125:3936-3946. [DOI: 10.1002/cncr.32435] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022]
Affiliation(s)
- José M. Amenábar
- Stomatology Department Federal University of Parana Curitiba Parana Brazil
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovations Queensland University of Technology Brisbane Queensland Australia
| | | | - Kai D. Tang
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovations Queensland University of Technology Brisbane Queensland Australia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovations Queensland University of Technology Brisbane Queensland Australia
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Risk of Human Papillomavirus Infection in Cancer-Prone Individuals: What We Know. Viruses 2018; 10:v10010047. [PMID: 29361695 PMCID: PMC5795460 DOI: 10.3390/v10010047] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 02/06/2023] Open
Abstract
Human papillomavirus (HPV) infections cause a significant proportion of cancers worldwide, predominantly squamous cell carcinomas (SCC) of the mucosas and skin. High-risk HPV types are associated with SCCs of the anogenital and oropharyngeal tract. HPV oncogene activities and the biology of SCCs have been intensely studied in laboratory models and humans. What remains largely unknown are host tissue and immune-related factors that determine an individual's susceptibility to infection and/or carcinogenesis. Such susceptibility factors could serve to identify those at greatest risk and spark individually tailored HPV and SCC prevention efforts. Fanconi anemia (FA) is an inherited DNA repair disorder that is in part characterized by extreme susceptibility to SCCs. An increased prevalence of HPV has been reported in affected individuals, and molecular and functional connections between FA, SCC, and HPV were established in laboratory models. However, the presence of HPV in some human FA tumors is controversial, and the extent of the etiological connections remains to be established. Herein, we discuss cellular, immunological, and phenotypic features of FA, placed into the context of HPV pathogenesis. The goal is to highlight this orphan disease as a unique model system to uncover host genetic and molecular HPV features, as well as SCC susceptibility factors.
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