Spectrum of Mutations in Chorionic Villous Samples for Prenatal Diagnosis of Thalassemia in Patients Presenting at a Tertiary Care Diagnostic Centre
DOI:
https://doi.org/10.51253/pafmj.v74i6.6997Keywords:
Beta Thalassemia, Chorionic Villi Sampling, Heterozygous, Homozygous, Molecular AnalysisAbstract
Objective: To determine the spectrum of mutations in chorionic villous samples (CVS) for prenatal diagnosis of thalassemia in patients presenting at a tertiary care diagnostic centre.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology (AFIP) Rawalpindi, Pakistan, from Jul 2020 to Jan 2021.
Methodology: Chorionic villous sampling (CVS) was performed between the 12th and 16th weeks of pregnancy. A transabdominal technique was used to obtain placental specimen. The couples' blood samples were collected in vials coated with ethylene diamine tetra acetic acid (EDTA). Chelex technique was used to extract genomic DNA. For genetic analysis of mutations, the Amplification Refractory Mutation System - Polymerase Chain Reaction (ARMS-PCR) was used.
Results: A total of ninety-four women underwent chorionic villous sampling. After DNA analysis, β-thalassemia major was diagnosed in 18(18.9%), β-thalassemia trait found in 52(55.3%) cases and no mutation was detected in 24(25.5%) cases. Among the patients diagnosed with β-thalassemia major, 15(83.33%) were homozygous and remaining 3(33.33%) were compound heterozygous.
Conclusion: Prenatal chorionic villous sampling and molecular analysis is useful in identifying β-thalassemia and β- thalassemia trait during pregnancy.
Downloads
References
Monni G, Peddes C, Iuculano A, Ibba RM. From Prenatal to Preimplantation Genetic Diagnosis of β-Thalassemia. Prevention Model in 8748 Cases: 40 Years of Single Center Experience. J Clin Med 2018; 7(2): 35. https://doi.org/10.3390/jcm7020035
Ghafoor M, Sabar MF, Sabir F. Prevention programmes and prenatal diagnosis for beta thalassemia in Pakistan: A narrative review. J Pak Med Assoc 2021; 71(1): 326-331.
https://doi.org/10.47391/jpma.665
Tasneem S, Sultana N, Snover A, Alam K. Clinical utility of red blood cell count, red cell distribution width: will it provide more accurate differentiation of Beta thalassemia trait and iron deficiency anemia in pregnancy. Rawal Med J 2016; 41(4): 424-427.
Faulkner L, Uderzo C, Khalid S. ATG vs thiotepa with busulfan and cyclophosphamide in matched-related bone marrow transplantation for thalassemia. Blood Adv 2017; 1(13): 792-801. https://doi.org/10.1182/bloodadvances.2016004119
Syed S, Shafi F, Yasmeen L, Noreen H, Chaudhri R. Pre-Natal Diagnosis of beta – Thalassemia by Chorionic Villous Sampling. J Rawal Med Coll 2009; 13(2): 83-85.
Mahay BS, Arora V, Puri R, Lall M, Saxena R, Verma J, et al. The changing scenario in prenatal diagnosis of genetic disorders: Genetics to genomics. Curr Med Res Pract 2018; 8(2): 203-208. https://doi.org/10.1016/j.cmrp.2018.11.004
Colah R, Italia K, Gorakshakar A. Burden of thalassemia in India: The road map for control. Pediatr Hematol Oncol J 2017; 2(4): 79-84. https://doi.org/10.1016/j.phoj.2017.10.002
Ishfaq F, Abid H, Kokab F. Awareness among parents of beta thalassemia major parents regarding prenatal diagnosis and premarital diagnosis. J Coll Phys Surg Pak 2012; 2(4): 77-81.
Shah PS, Shah ND, Ray HSP, Khatri NB, Vaghasia KK, Raval RJ, et al. Mutation analysis of β-thalassemia in East-Western Indian population. A recent molecular approach. Appl Clin Genet 2017; 10: 27-35. http://dx.doi.org/10.2147/TACG.S127531
Kanwal S, Bukhari S, Perveen S. Molecular genetics and prenatal diagnosis of beta thalassemia to control transfusion dependent births in carrier Pakistani couples. J Pak Med Assoc 2017; 67(7): 1030-1034.
Kumar R, Arya V, Agarwal S. Profiling β thalassemia mutations in consanguinity and non-consanguinity for prenatal screening and awareness programme. Adv Hematol 2015; 2015: 625721. https://doi.org/10.1155/2015/625721
12.Li D-Z, Yang Y-D. Invasive prenatal diagnosis of fetal thalassemia. Best Pract Res Clin Obstet Gynaecol 2017; 39(2): 41-52. https://doi.org/10.1016/j.bpobgyn.2016.10.011
Rueangchainikhom W, Sarapak S, Orungrote N. Chorionic Villus Sampling for Early Prenatal Diagnosis at Bhumibol Adulyadej Hospital. J Med Assoc Thai 2008; 91(1): 1-6
Taher AT, Musallam KM, Cappellini MD.. β-Thalassemias. N Engl J Med 2021; 384: 727-743.
https://doi.org/10.1056/nejmra2021838
Khan M, Asif M, Yaqoob N, Anwar T, Hassan K. Prenatal diagnosis of thalassemia: practices among parents of thalassemia major patients. J Islam Med Dent Coll 2012(2): 77-80.
16.Syed S, Shafi F, Yasmeen L, Noreen H, Chaudhri R. Pre-Natal Diagnosis of beta – Thalassemia by Chorionic Villous Sampling. J Rawal Med Coll 2009; 13(2): 83-85.
Kazmi J, Ansari SH, Ahmed G, Perveen K. Prenatal diagnosis for haemoglobinopathy: a single centre experience. Proceedings Haematology Conference, Karachi 2009.
Arif F, Fayyaz J, Hamid A. Awareness among parents of children with thalassemia major. J Pak Med Assoc 2008; 58: 621-624.
Sorathiya VP, Colah RB, Vachhani NA, Nandani SL, Vekariya DJ, Kashiyani HN. Molecular analysis and prenatal diagnosis of β thalassemias in the Saurashtra region of Gujarat. Int J Community Med Pub Health 2020; 7(5): 1977-1981.
http://dx.doi.org/10.18203/2394-6040.ijcmph20202017
Baig S, Azhar A, Hassan H. Spectrum of beta-thalassemia mutations in various regions of Punjab and Islamabad, Pakistan: establishment of prenatal diagnosis. Haematologica 2006; 91(03): 02.
Zafar U, Naseem K, Baig M. The Spectrum of Beta-thalassemia Mutations in Couples Referred for Chorionic Villus Sampling at Bahawal Victoria Hospital, Bahawalpur. Cureus 2018; 10(9): e3265. https://doi.org/10.7759/cureus.3265
Sharma S, Seth B, Jawade P, Ingale M, Setia MS. Quality of life in children with thalassemia and their caregivers in India. Indian J Pediatr 2017; 84(3): 188-194.
https://doi.org/10.1007/s12098-016-2267-z
Garawal G, Das R, Anasthi A. The clinical significance of the spectrum of interaction of CAP+1 (A-C), a silent beta globin gene mutation, with other beta thalassemia mutations and globin gene modifiers in north Indians. Eur J Haematol 2007; 79(5): 417-421. https://doi.org/10.1111/j.1600-0609.2007.00958.x
Maragoudaki E, Kanavakis E, Traeger‐Synodinos J, Vrettou C, Tzetis M, Metaxotou‐Mavrommati A, et al. Molecular, haematological and clinical studies of the− 101 C→ T substitution of the β‐globin gene promoter in 25 β‐thalassaemia intermedia patients and 45 heterozygotes. Br J Haematol 1999; 107(4): 699-706.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Annum Sardar, Helen Mary Robert, Fahim Akhtar, Asad Mahmood, Sadia Ali, Saima Zahir
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.