ABSTRACT
Germline mutations in tubulin beta class I (TUBB), which encodes one of the ß-tubulin isoforms, were previously associated with neurological and cutaneous abnormalities. Here, we describe the first case of inherited bone marrow (BM) failure, including marked thrombocytopenia, morphological abnormalities, and cortical dysplasia, associated with a de novo p.D249V variant in TUBB. Mutant TUBB had abnormal cellular localisation in transfected cells. Following interferon/ribavirin therapy administered for transfusion-acquired hepatitis C, severe pancytopenia and BM aplasia ensued, which was unresponsive to immunosuppression. Acquired chromosome arm 6p loss of heterozygosity was identified, leading to somatic loss of the mutant TUBB allele.
Subject(s)
Pancytopenia , Thrombocytopenia , Humans , Tubulin/genetics , Pancytopenia/genetics , Chromosome Deletion , Thrombocytopenia/genetics , Bone Marrow Failure Disorders/genetics , Germ CellsABSTRACT
Prolonged exposure to combined hormone replacement therapy (estrogen plus progestin) increases a woman's risk of breast cancer, whereas estrogen-only hormone replacement therapy does not. This suggests that progesterone may play a role in breast carcinogenesis. Association studies have reported inconsistent relationships between progesterone receptor gene variants and breast cancer. A population-based case-control study in three counties of the Philadelphia Metropolitan area was undertaken. We evaluated 8 PGR candidate SNPs and 18 PGR tagging SNPS in 487 breast cancer cases and 843 controls using multivariable logistic regression with adjustment for combined hormone replacement therapy use. Separate analyses were conducted for European Americans (EA: 399 cases, 490 controls) and African Americans (AA: 88 cases, 353 controls). In EAs, no significant associations were observed with the investigated PGR variants. In AAs, two tagging SNPs (rs590688 and rs10895054) were statistically significantly associated with breast cancer. For rs590688, each addition of the C allele was protective compared to the G allele (OR = 0.56, 95 % CI 0.39-0.82, p value 0.003, corrected p value 0.03). For rs10895054, each addition of the T allele increased the risk of breast cancer compared to the A allele nearly threefold (OR = 2.9, 95 % CI 1.47-6.02, p value 0.002, corrected p value 0.04). Three haplotype blocks, all containing rs590688, were found to be significantly associated with breast cancer risk. Environmental exposures, namely parity and obesity modified the effect of both SNPs on breast cancer risk in EA. This is the first study to find an association between two PGR variants and breast cancer in AA women. These results suggest that studies of PGR variants in other non-White populations may reveal additional cancer associations of interest.
Subject(s)
Black or African American/genetics , Breast Neoplasms/genetics , Genetic Predisposition to Disease , Polymorphism, Single Nucleotide , Receptors, Progesterone/genetics , Aged , Aged, 80 and over , Case-Control Studies , Female , Haplotypes , Heterozygote , Homozygote , Humans , Logistic Models , Middle Aged , PhiladelphiaSubject(s)
Lymphoma, Large B-Cell, Diffuse/complications , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/physiopathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Diagnosis, Differential , Female , Hepatomegaly/etiology , Humans , Middle Aged , Quadriplegia/etiology , Splenomegaly/etiologyABSTRACT
Although uncommon, breast cancer in young women is worthy of special attention due to the unique and complex issues that are raised. This article reviews specific challenges associated with the care of younger breast cancer patients, which include fertility preservation, management of inherited breast cancer syndromes, maintenance of bone health, secondary prevention, and attention to psychosocial issues.
