There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Severe congenital neutropenia (CN) stands for a group of disorders characterised by
extremely low neutrophil counts (ANC < 0.5x109), early stage maturation arrest of
myelopoiesis and recurrent bacterial infections. In general more than 90% of CN patients
respond to daily G-CSF treatment with a sustained neutrophil increase resulting in
significantly reduced infections and an improved quality of life. Besides neutropaenia,
the differences in treatment response and the presence of various concomitant clinical
features in subpopulations of patients in conjunction with an increased risk of leukaemia
transformation in about 10% of all CN patients strongly suggested to search for new
sub diagnoses to identify patients at risk of leukaemia.
Within Europe the SCNIR has collected longitudinal clinical data on more than 493
patients with various causes of CN (289 congenital, 64 cyclic, 132 idiopathic and
8 others) from 22 countries. This unique resource of data was used to identify new
genes, classify patients by genetic subtypes of CN, estimate their relative frequency
and correlate genetic subtypes with prognosis and outcome.
To date, more than 10 disease causing gene mutations have be identified in congenital
neutropaenia patients. In approximately 50-60% of all patients autosomal dominant
mutations in the ELANE gene are present. Initial genotype-phenotype correlation identified
a group of different genetic defects sharing a high risk of leukaemia transformation
in contrast to others with no increased risk of leukaemia.
The identification of new CN subtypes, their distinctive risk of malignant transformation
and the response to treatment has contributed substantially to our general understanding
of neutropaenia. New risk adapted strategies for diagnosis and treatment have to be
implemented in the management of CN patients.