GATA2 deficiency: A protean disorder of hematopoiesis, lymphatics, and immunity

Michael A. Spinner, Lauren A. Sanchez, Amy P. Hsu, Pamela A. Shaw, Christa S. Zerbe, Katherine R. Calvo, Diane C. Arthur, Wenjuan Gu, Christine M. Gould, Carmen C. Brewer, Edward W. Cowen, Alexandra F. Freeman, Kenneth N. Olivier, Gulbu Uzel, Adrian M. Zelazny, Janine R. Daub, Christine D. Spalding, Reginald J. Claypool, Neelam K. Giri, Blanche P. AlterEmily M. Mace, Jordan S. Orange, Jennifer Cuellar-Rodriguez, Dennis D. Hickstein, Steven M. Holland

Research output: Contribution to journalArticle

Abstract

Haploinsufficiency of the hematopoietic transcription factor GATA2 underlies monocytopenia andmycobacterial infections; dendritic cell,monocyte,B, and natural killer (NK) lymphoid deficiency; familial myelodysplastic syndromes (MDS)/acute myeloid leukemia (AML); and Emberger syndrome (primary lymphedema with MDS). A comprehensive examination of the clinical features ofGATA2 deficiency is currently lacking.We reviewed the medical records of 57 patients with GATA2 deficiency evaluated at the National Institutes of Health from January 1, 1992, to March 1, 2013, and categorized mutations as missense, null, or regulatory to identify genotype-phenotype associations. We identified a broad spectrum of disease: hematologic (MDS 84%, AML 14%, chronic myelomonocytic leukemia8%), infectious (severe viral 70%, disseminatedmycobacterial 53%, and invasive fungal infections 16%), pulmonary (diffusion 79%and ventilatory defects 63%, pulmonary alveolar proteinosis 18%, pulmonary arterial hypertension 9%), dermatologic (warts 53%, panniculitis 30%), neoplastic (human papillomavirus+ tumors 35%, Epstein-Barr virus+ tumors 4%), vascular/lymphatic (venous thrombosis 25%, lymphedema 11%), sensorineural hearing loss 76%, miscarriage 33%, and hypothyroidism 14%. Viral infections and lymphedemaweremore common in individualswith nullmutations (P = .038 and P = .006, respectively). Monocytopenia, B, NK, and CD4 lymphocytopenia correlated with the presence of disease (P <.001). GATA2 deficiency unites susceptibility to MDS/AML, immunodeficiency, pulmonary disease, and vascular/lymphatic dysfunction. Early genetic diagnosis is critical to direct clinical management, preventive care, and family screening.

Original languageEnglish (US)
Pages (from-to)809-821
Number of pages13
JournalBlood
Volume123
Issue number6
DOIs
StatePublished - Feb 6 2014
Externally publishedYes

Fingerprint

Myelodysplastic Syndromes
Hematopoiesis
Tumors
GATA2 Transcription Factor
Immunity
Acute Myeloid Leukemia
Pulmonary diseases
Lymphedema
Audition
Viruses
Blood Vessels
Screening
Pulmonary Alveolar Proteinosis
Health
Panniculitis
Haploinsufficiency
Defects
Lymphopenia
Preventive Medicine
Warts

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Spinner, M. A., Sanchez, L. A., Hsu, A. P., Shaw, P. A., Zerbe, C. S., Calvo, K. R., ... Holland, S. M. (2014). GATA2 deficiency: A protean disorder of hematopoiesis, lymphatics, and immunity. Blood, 123(6), 809-821. https://doi.org/10.1182/blood-2013-07-515528

GATA2 deficiency : A protean disorder of hematopoiesis, lymphatics, and immunity. / Spinner, Michael A.; Sanchez, Lauren A.; Hsu, Amy P.; Shaw, Pamela A.; Zerbe, Christa S.; Calvo, Katherine R.; Arthur, Diane C.; Gu, Wenjuan; Gould, Christine M.; Brewer, Carmen C.; Cowen, Edward W.; Freeman, Alexandra F.; Olivier, Kenneth N.; Uzel, Gulbu; Zelazny, Adrian M.; Daub, Janine R.; Spalding, Christine D.; Claypool, Reginald J.; Giri, Neelam K.; Alter, Blanche P.; Mace, Emily M.; Orange, Jordan S.; Cuellar-Rodriguez, Jennifer; Hickstein, Dennis D.; Holland, Steven M.

In: Blood, Vol. 123, No. 6, 06.02.2014, p. 809-821.

Research output: Contribution to journalArticle

Spinner, MA, Sanchez, LA, Hsu, AP, Shaw, PA, Zerbe, CS, Calvo, KR, Arthur, DC, Gu, W, Gould, CM, Brewer, CC, Cowen, EW, Freeman, AF, Olivier, KN, Uzel, G, Zelazny, AM, Daub, JR, Spalding, CD, Claypool, RJ, Giri, NK, Alter, BP, Mace, EM, Orange, JS, Cuellar-Rodriguez, J, Hickstein, DD & Holland, SM 2014, 'GATA2 deficiency: A protean disorder of hematopoiesis, lymphatics, and immunity', Blood, vol. 123, no. 6, pp. 809-821. https://doi.org/10.1182/blood-2013-07-515528
Spinner MA, Sanchez LA, Hsu AP, Shaw PA, Zerbe CS, Calvo KR et al. GATA2 deficiency: A protean disorder of hematopoiesis, lymphatics, and immunity. Blood. 2014 Feb 6;123(6):809-821. https://doi.org/10.1182/blood-2013-07-515528
Spinner, Michael A. ; Sanchez, Lauren A. ; Hsu, Amy P. ; Shaw, Pamela A. ; Zerbe, Christa S. ; Calvo, Katherine R. ; Arthur, Diane C. ; Gu, Wenjuan ; Gould, Christine M. ; Brewer, Carmen C. ; Cowen, Edward W. ; Freeman, Alexandra F. ; Olivier, Kenneth N. ; Uzel, Gulbu ; Zelazny, Adrian M. ; Daub, Janine R. ; Spalding, Christine D. ; Claypool, Reginald J. ; Giri, Neelam K. ; Alter, Blanche P. ; Mace, Emily M. ; Orange, Jordan S. ; Cuellar-Rodriguez, Jennifer ; Hickstein, Dennis D. ; Holland, Steven M. / GATA2 deficiency : A protean disorder of hematopoiesis, lymphatics, and immunity. In: Blood. 2014 ; Vol. 123, No. 6. pp. 809-821.
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