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Gueye Tall F, Martin C, Ndour EHM, Renoux C, Ly ID, Connes P, Gueye PM, Diallo RN, Diagne I, Diop PA, Cissé A, Lopez Sall P, Joly P. Combined and differential effects of alpha-thalassemia and HbF-quantitative trait loci in Senegalese hydroxyurea-free children with sickle cell anemia. Pediatr Blood Cancer 2019; 66:e27934. [PMID: 31322815 DOI: 10.1002/pbc.27934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/16/2019] [Accepted: 07/07/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Our objective was to investigate the combined and differential effects of alpha-thalassemia -3.7 kb deletion and HbF-promoting quantitative trait loci (HbF-QTL) in Senegalese hydroxyurea (HU)-free children and young adults with sickle cell anemia (SCA). PROCEDURE Steady-state biological parameters and vaso-occlusive crises (VOC) requiring emergency admission were recorded over a 2-year period in 301 children with SCA. The age of the first hospitalized VOC was also recorded. These data were correlated with the alpha-globin and HbF-QTL genotypes. For the latter, three different genetic loci were studied (XmnI, rs7482144; BCL11A, rs1427407; and the HBS1L-MYB region, rs28384513) and a composite score was calculated, ranging from zero (none of these three polymorphisms) to six (all three polymorphisms at the homozygous state). RESULTS A positive clinical impact of the HbF-QTL score on VOC rate, HbF, leucocytes, and C-reactive protein levels was observed only for patients without alpha-thalassemia deletion. Conversely, combination of homozygous -3.7 kb deletion with three to six HbF-QTL was associated with a higher VOC rate. The age of the first hospitalized VOC was delayed for patients with one or two alpha-thalassemia deletions and at least two HbF-QTL. CONCLUSION Alpha-thalassemia -3.7 kb deletion and HbF-QTL are modulating factors of SCA clinical severity that interact with each other. They should be studied and interpreted together and not separately, at least in HU-free children.
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Affiliation(s)
- Fatou Gueye Tall
- Laboratoire de Biochimie Pharmaceutique-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal.,Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal
| | - Cyril Martin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France
| | - El Hadji Malick Ndour
- Laboratoire de Biochimie Pharmaceutique-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal.,Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,UF "Biochimie des pathologies érythrocytaires", Laboratoire de Biochimie et Biologie moléculaire Grand-Est, Groupement hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Indou Déme Ly
- Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.,Service universitaire de Pédiatrie-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,Institut Universitaire de France, Paris, France
| | - Papa Madieye Gueye
- Laboratoire de Biochimie Pharmaceutique-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Rokhaya Ndiaye Diallo
- Laboratoire de Biochimie Pharmaceutique-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Ibrahima Diagne
- Service universitaire de Pédiatrie-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal.,UFR des sciences de la santé - Université Gaston Berger, Saint-Louis, Sénégal
| | - Pape Amadou Diop
- Laboratoire de Biochimie Pharmaceutique-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Aynina Cissé
- Laboratoire de Biochimie Pharmaceutique-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Philomène Lopez Sall
- Laboratoire de Biochimie Pharmaceutique-FMPO, Université Cheikh Anta Diop, Dakar, Sénégal.,Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE, Lyon, France.,Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,UF "Biochimie des pathologies érythrocytaires", Laboratoire de Biochimie et Biologie moléculaire Grand-Est, Groupement hospitalier Est, Hospices Civils de Lyon, Bron, France
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Friedrisch JR, Sheehan V, Flanagan JM, Baldan A, Summarell CCG, Bittar CM, Friedrisch BK, Wilke II, Ribeiro CB, Daudt LE, da Rocha Silla LM. The role of BCL11A and HMIP-2 polymorphisms on endogenous and hydroxyurea induced levels of fetal hemoglobin in sickle cell anemia patients from southern Brazil. Blood Cells Mol Dis 2016; 62:32-37. [PMID: 27838552 DOI: 10.1016/j.bcmd.2016.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/04/2016] [Accepted: 11/07/2016] [Indexed: 01/18/2023]
Abstract
High levels of fetal hemoglobin (HbF) reduce sickle cell anemia (SCA) morbidity and mortality. HbF levels vary considerably and there is a strong genetic component that influences HbF production. Genetic polymorphisms at three quantitative trait loci (QTL): Xmn1-HBG2, HMIP-2 and BCL11A, have been shown to influence HbF levels and disease severity in SCA. Hydroxyurea (HU) is a drug that increases HbF. We investigated the influence of single nucleotide polymorphisms (SNPs) at the Xmn1-HBG2 (rs7482144); BCL11A (rs1427407, rs4671393 and rs11886868); and HMIP-2 (rs9399137 and rs9402686) loci on baseline and HU-induced HbF levels in 111 HbSS patients. We found that both BCL11A and HMIP-2 were associated with increased endogenous levels of HbF. Interestingly, we also found that BCL11A was associated with higher induction of HbF with HU. This effect was independent of the effect of BCL11A on baseline HbF levels. Additional studies will be needed to validate these findings and explain the ample inter-individual variations in HbF levels at baseline and HU-induced in patients with SCA.
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Affiliation(s)
- João Ricardo Friedrisch
- Medical Sciences, Universidade Federal do Rio Grande do Sul (UFGRS); Hematology and Bone Marrow Transplantation Service of the Hospital de Clínicas de Porto Alegre (HCPA).
| | - Vivien Sheehan
- Texas Children's Hematology Center, Baylor College of Medicine, Department of Pediatrics, Houston, TX, USA.
| | - Jonathan M Flanagan
- Texas Children's Hematology Center, Baylor College of Medicine, Department of Pediatrics, Houston, TX, USA.
| | - Alessandro Baldan
- Texas Children's Hematology Center, Baylor College of Medicine, Department of Pediatrics, Houston, TX, USA.
| | - Carly C Ginter Summarell
- Texas Children's Hematology Center, Baylor College of Medicine, Department of Pediatrics, Houston, TX, USA.
| | | | | | - Ianaê Indiara Wilke
- Hematology and Bone Marrow Transplantation Service of the Hospital de Clínicas de Porto Alegre (HCPA).
| | - Camila Blos Ribeiro
- Hematology and Bone Marrow Transplantation Service of the Hospital de Clínicas de Porto Alegre (HCPA).
| | - Liane Esteves Daudt
- Hematology and Bone Marrow Transplantation Service of the Hospital de Clínicas de Porto Alegre (HCPA).
| | - Lucia Mariano da Rocha Silla
- Hematology and Bone Marrow Transplantation Service of the Hospital de Clínicas de Porto Alegre (HCPA); Medical Sciences, UFGRS, Santa Cruz do Sul, RS, Brazil.
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Nunes S, Argollo N, Mota M, Vieira C, Sena EPD. Comprehensive neuropsychological evaluation of children and adolescents with sickle cell anemia: a hospital-based sample. Rev Bras Hematol Hemoter 2016; 39:32-39. [PMID: 28270343 PMCID: PMC5339374 DOI: 10.1016/j.bjhh.2016.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 08/04/2016] [Accepted: 09/12/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Individuals with sickle cell anemia may suffer symptomatic or silent cerebral infarcts leading to neurocognitive complications. This study investigated the cognitive and intellectual performance of children and adolescents with sickle cell anemia. METHODS The socioeconomic status, clinical aspects and behavioral profile of 15 young individuals with sickle cell anemia were evaluated. The Wechsler Intelligence Scale for Children, the Developmental Neuropsychological Assessment Test, and the Child Behavior Checklist were applied. RESULTS Participants with a history of stroke had lower intelligence quotient (IQ) scores. Alterations were found in attention and executive functioning, language, verbal and visual memory, visuospatial processing and sensorimotor skills. These alterations were found both in the children and adolescents who had had a cerebral infarction and in those who apparently had not. In the majority of cases, there were learning difficulties, a history of repeating school years and a need for specialist educational support. The most common additional diagnoses in accordance with the Diagnostic and Statistical Manual of Mental Disorders IV were depressive disorder, anxiety disorder and somatic disorder, as well as conditions associated with physical and psychosocial repercussions of sickle cell anemia. CONCLUSION As sickle cell anemia is considered a progressive cerebral vasculopathy, it is a potential risk factor for neurocognitive and psychosocial development. Therefore, periodic neuropsychological and behavioral evaluations of children and adolescents with sickle cell anemia may represent a useful measure to reduce long-term biopsychosocial repercussions.
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Affiliation(s)
- Samantha Nunes
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
| | - Nayara Argollo
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Marivania Mota
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Camilo Vieira
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
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