Background
Methods
Patients
Next generation sequencing (NGS)
Statistics analysis
Results
KMT2A variants
Patient ID | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | |
---|---|---|---|---|---|---|---|---|---|
Gender | F | M | M | F | M | F | F | F | |
Gestation (weeks) | 35 | Full term | Full term | 35 | Full term | Full term | Full term | Full term | |
Birth height (cm)/weight (kg) | 49/2.9 | Unknown/3.1 | 50/3.2 | 43/1.9 | 50/3.2 | Unknown/3.4 | Unknown/3.3 | Unknown/3.8 | |
Age at last examination | 3-year-3-month | 3-year | 6-year-7-month | 5-year | 5-year-7-month | 8-year-10-month | 25-year | 9-year-10-month | |
Current height (cm)/weight (kg) | 92 (−1.75 SD)/ 11.8 (−2.30 SD) | 85(−3.16 SD)/ 11.0(− 2.67 SD) | 106 (− 3.18 SD)/ 16.2 (− 2.51SD) | 96.5 (−5.32 SD)/ 13.5 (− 4.12 SD) | 105(−2.26 SD)/ 18.0 (− 1.09 SD) | 131 (−0.34 SD)/ 32.5 (+ 1.01 SD) | 158 (− 0.57 SD)/ 65 (+ 1.68 SD) | 107 (− 4.72 SD)/ 17.0(− 1.90 SD) | |
Craniofacial features | |||||||||
Microcephaly (HPO:0000252) | + | + | + | – | – | – | – | – | |
Macrocephaly (HPO:0000256) | – | – | – | – | – | – | + | – | |
Prominent forehead (HPO:0011220) | + | + | – | – | + | + | – | – | |
Hypertelorism (HPO:0000316) | + | + | + | + | + | + | – | + | |
Ptosis (HPO:0000508) | – | + | + | – | – | – | + | + | |
Epicanthus (HPO:0000286) | – | – | – | – | – | – | – | – | |
Down-turned palpebral fissures (HPO:0000494) | + | + | + | + | + | – | – | + | |
Wide nasal bridge (HPO:0000431) | + | + | – | + | + | + | – | + | |
Depressed nasal bridge (HPO:0005280) | + | + | – | + | – | + | – | + | |
Long philtrum (HPO:0000343) | – | + | + | – | + | + | – | – | |
Low set ears (HPO:0000368) | – | + | + | + | – | – | – | – | |
External ear deformity(HPO:0040111) | – | – | – | – | – | – | – | – | |
Thin upper lip (HPO:0000219) | + | + | + | – | + | – | – | – | |
Down-turned corners of the mouth (HPO:0000153) | + | + | + | + | + | – | – | + | |
Micrognathia (HPO:0000347) | – | – | + | + | + | + | – | – | |
Skeletal anomalies | |||||||||
Advanced bone age (HPO:0200001) | nd | nd | nd | – | + | + | nd | – | |
Delayed bone age (HPO:0003799) | nd | nd | nd | + | – | – | nd | + | |
Brachydactyly (HPO:0001156) | – | – | – | + | + | + | + | – | |
Syndactyly (HPO:0001159) | – | – | – | – | – | – | – | – | |
Clinodactyly (HPO:0030084) | – | – | – | – | + | + | + | – | |
Puffy hands and feet | – | – | – | + | – | – | + | + | |
Small hands and feet | – | – | – | + | – | – | + | + | |
Carpal epiphyseal growth retardation | nd | nd | nd | – | – | – | – | – | |
Scoliosis (HPO:0002650) | – | – | – | – | – | – | – | – | |
Sacral dimple (HPO:0000960) | – | – | – | – | – | – | – | + | |
Absent palmar proximal transverse creases (HPO:0010489) | – | – | – | – | – | – | – | – | |
Deep palmar crease (HPO:0006191) | – | – | – | – | – | – | – | – | |
Hairiness | |||||||||
Thick hair (HPO:0100874) | + | + | + | – | – | + | + | + | |
Thick eyebrows (HPO:0000574) | – | – | – | – | – | + | + | + | |
Synophrys (HPO:0000664) | – | – | – | – | – | – | + | – | |
Arched eyebrows (HPO:0002553) | – | + | – | – | + | – | + | – | |
Long eyelashes (HPO:0000527) | + | + | + | + | + | + | – | + | |
Low hair line (HPO:0000294) | + | + | + | + | + | – | + | + | |
Hypertrichosis, cubiti (HPO:0000998) | – | – | – | – | – | + | + | + | |
Hypertrichosis, back (HPO:0000998) | mild | mild | – | + | mild | mild | + | mild | |
Hypertrichosis, lower limbs (HPO:0000998) | – | – | – | – | – | – | – | + | |
Developmental and neurology | |||||||||
Walking delay (HPO:0031936) | – | + | – | – | + | – | – | – | |
Language delay (HPO:0000750) | + | + | + | – | + | – | + | + | |
Intellectual disability (HPO:0001249) | mild | + | + | nd | + | – | + | + | |
Aggressive behavior (HPO:0000718) | – | + | + | – | + | – | – | – | |
Hyperactivity (HPO:0007018) | – | – | – | – | + | – | – | + | |
Autism (HPO:0000717) | – | – | – | – | + | – | – | – | |
Organic problems | |||||||||
Strabismus (HPO:0000486) | – | – | – | – | – | – | – | – | |
Hyperopia (HPO:0008499) | – | – | + | – | – | – | – | – | |
High palate (HPO:0000218) | – | – | + | + | + | + | + | + | |
Cleft palate (HPO:0000175) | + | – | – | – | – | – | – | ||
Glossoptosis (HPO:0000162) | – | – | – | – | – | – | – | – | |
Feeding difficulties (HPO:0011968) | + | – | – | – | + | – | – | – | |
Cardiac anomaly | – | – | – | – | PDA | – | – | – | |
Dyslipidemia | – | – | – | – | – | – | – | – | |
Abnormality of the teeth (HPO:0000164) | – | – | + | – | + | – | – | + | |
GH deficiency (HPO:0000824) | ne | ne | + | + | ne | ne | ne | ne | |
KMT2A variant | p.Pro1281Leufs*75 | p.Gly3585Argfs*8 | p.Ser774Valfs*12 | p.Arg3906Cys | p.Gly1168Asp | p.Arg1081* | p.Ser774Valfs*12 | c.10900 + 2 T > C | |
This study | Sun et al.2017 (ref 6) | Chinese patients (N = 16; %) | |||||||
Patient ID | 9 | 10 | 11 | 12 | 13 | 14 | A.II-5 | B.II-1 | |
Gender | M | M | F | M | F | F | M | M | 8 M/8F |
Gestation (weeks) | Full term | Full term | 38+ 5 | Full term | 35+ 5 | 38+ 5 | nd | nd | |
Birth height (cm)/weight (kg) | Unknown | Unknown/2.6 | 51/2.9 | 50/2.9 | 46/2.5 | Unknown /2.3 | nd | nd | |
Age at last examination | 12-year | 6-year-9-month | 18-month | 4-year | 17-month | 20-month | 3-year | 6-year | |
Current height (cm)/weight (kg) | 118 (−3.16 SD)/ 19.5 (−3.76 SD) | 102.8 (−4.18 SD) /15.7 (− 3.06 SD) | 72 (− 3.28 SD) / 8.0 (−2.75 SD) | 100.5 (−0.89 SD)/ 15.4 (0.47 SD) | 66.0 (−6.25 SD)/ 6.7 (− 4.13 SD) | 66.0 (−5.90 SD) / 7.1 (− 4.16 SD) | <-2SD/nd | <-2SD/nd | |
Craniofacial features | |||||||||
Microcephaly (HPO:0000252) | + | + | – | – | – | + | + | + | 8/16; 50% |
Macrocephaly (HPO:0000256) | – | – | – | – | – | – | – | – | 1/16; 6% |
Prominent forehead (HPO:0011220) | + | – | + | – | + | – | – | – | 7/16; 44% |
Hypertelorism (HPO:0000316) | – | – | + | + | + | + | + | + | 13/16; 81% |
Ptosis (HPO:0000508) | + | – | + | + | – | + | + | + | 10/16; 63% |
Epicanthus (HPO:0000286) | – | + | – | – | – | – | – | + | 2/16; 13% |
Down-turned palpebral fissures (HPO:0000494) | + | – | + | + | + | – | + | + | 12/16; 75% |
Wide nasal bridge (HPO:0000431) | – | – | + | + | – | + | + | – | 10/16; 63% |
Depressed nasal bridge (HPO:0005280) | – | – | + | + | – | – | + | + | 9/16; 56% |
Long philtrum (HPO:0000343) | – | – | + | + | + | – | + | + | 9/16; 56% |
Low set ears (HPO:0000368) | – | + | – | + | – | – | + | – | 6/16; 38% |
External ear deformity (HPO:0040111) | – | + | – | + | – | – | 2/16; 13% | ||
Thin upper lip (HPO:0000219) | + | + | + | + | – | – | + | + | 8/16; 50% |
Down-turned corners of the mouth (HPO:0000153) | – | – | + | + | + | – | + | + | 13/16; 81% |
Micrognathia (HPO:0000347) | – | – | – | – | + | – | 7/16; 44% | ||
Skeletal anomalies | |||||||||
Advanced bone age (HPO:0200001) | – | – | – | – | nd | nd | – | – | 2/10; 20% |
Delayed bone age (HPO:0003799) | + | + | + | – | nd | nd | + | + | 7/10; 70% |
Brachydactyly (HPO:0001156) | – | + | – | + | – | + | – | + | 8/16; 50% |
Syndactyly (HPO:0001159) | 2–3 toe | 2–3 toe | – | – | – | 2–3 toe | – | – | 3/16; 19% |
Clinodactyly (HPO:0030084) | – | – | + | – | – | – | – | 4/16; 25% | |
Puffy hands and feet | – | + | – | + | + | – | + | + | 8/16; 50% |
Small hands and feet | – | + | + | + | – | – | + | + | 8/16; 50% |
Carpal epiphyseal growth retardation | – | + | – | – | – | – | 1/13; 8% | ||
Scoliosis (HPO:0002650) | – | + | – | – | – | – | – | – | 1/16; 6% |
Sacral dimple (HPO:0000960) | + | + | – | – | – | – | + | – | 4/16; 25% |
Absent palmar proximal transverse creases (HPO:0010489) | – | – | – | – | – | – | + | + | 2/16; 13% |
Deep palmar crease (HPO:0006191) | + | – | – | – | – | – | – | – | 1/16; 6% |
Hairiness | |||||||||
Thick hair (HPO:0100874) | + | + | + | + | + | + | + | + | 14/16; 88% |
Thick eyebrows (HPO:0000574) | – | + | + | – | – | + | – | – | 6/16; 38% |
Synophrys (HPO:0000664) | – | – | – | – | – | – | – | – | 1/16; 6% |
Arched eyebrows (HPO:0002553) | – | + | + | – | – | + | – | – | 6/16; 44% |
Long eyelashes (HPO:0000527) | + | + | + | + | – | + | + | + | 15/16; 94% |
Low hair line (HPO:0000294) | + | + | + | – | – | + | + | + | 13/16; 81% |
Hypertrichosis, cubiti (HPO:0000998) | + | + | mild | mild | – | – | – | – | 7/16; 44% |
Hypertrichosis, back (HPO:0000998) | + | + | – | mild | mild | – | + | – | 12/16; 75% |
Hypertrichosis, lower limbs (HPO:0000998) | + | + | – | + | – | + | + | + | 8/16; 50% |
Developmental and neurology | |||||||||
Walking delay (HPO:0031936) | + | + | + | + | + | + | + | + | 10/16; 63% |
Language delay (HPO:0000750) | + | + | too young | + | too young | + | + | + | 12/14; 86% |
Intellectual disability (HPO:0001249) | + | + | + | + | + | + | + | + | 14/15; 93% |
Aggressive behavior (HPO:0000718) | – | – | – | + | – | – | – | – | 4/16; 25% |
Hyperactivity (HPO:0007018) | – | – | – | – | – | – | – | – | 2/16; 13% |
Autism (HPO:0000717) | – | – | – | – | – | – | – | – | 1/16; 6% |
Organic problems | |||||||||
Strabismus (HPO:0000486) | + | + | – | – | too young | too young | – | + | 3/14; 21% |
Hyperopia (HPO:0008499) | – | – | – | – | too young | too young | – | – | 1/14; 7% |
High palate (HPO:0000218) | + | + | – | + | + | + | – | + | 12/16; 75% |
Cleft palate (HPO:0000175) | – | – | – | – | + | – | – | – | 1/16; 6% |
Glossoptosis (HPO:0000162) | – | – | – | – | + | – | – | – | 1/15; 7% |
Feeding difficulties (HPO:0011968) | – | – | – | – | + | – | + | + | 5/16; 31% |
Cardiac anomaly | – | BAV | – | – | – | – | PDA | – | 3/16; 19% |
Dyslipidemia | – | + | – | – | – | – | – | – | 1/16; 6% |
Abnormality of the teeth (HPO:0000164) | + | + | – | + | + | – | – | – | 7/16; 44% |
GH deficiency (HPO:0000824) | ne | + | ne | ne | ne | ne | nd | nd | 3/3; 100% |
KMT2A variant | p.Gln3613* | p.Tyr1957* | Pro1354Leufs*2 | p.Glu2018fs*7 | p.Arg301* | p.Trp838lfs*9 | p.Gln2803* | p.Gln819* |
Clinical presentation
Intervention
Phenotypic comparison of the Chinese and French cohorts
Chinese cohort (N = 16; %) | French cohort (N = 33; %) (Ref. 11) | P value (χ2 test) | |
---|---|---|---|
General information | |||
Gender | F8 (50%)/M8 (50%) | F11 (33%)/M22 (67%) | 0.261 |
Age at last examination (years) | 1.5 to 25 | 3 to 36 | |
Postnatal growth retardation (H) | 12/16 (75%) | 15/32 (47%) | 0.064 |
Postnatal growth retardation (W) | 9/14 (64%) | 11/30 (37%) | 0..087 |
Postnatal growth retardation (H + W) (HPO:0008897) | 8/14 (57%) | 9/30 (30%) | 0.085 |
KMT2A variants | 15 different variants | 29 different variants | 0,639 |
Nonsense variants | 6 | 8 | |
Frameshift variants | 6 | 12 | |
Missense variants | 2 | 8 | |
Splicing variants | 1 | 1 | |
Craniofacial features | |||
Microcephaly (HPO:0000252) | 8/16 (50%) | 10/30 (33%) | 0.270 |
Hypertelorism (HPO:0000316) | 13/16 (81%) | 21/32 (66%) | 0.432 |
Ptosis (HPO:0000508) | 10/16 (63%) | 5/32 (16%) | 0.001 |
Down-turned palpebral fissures (HPO:0000494) | 12/16 (75%) | 18/31 (58%) | 0.252 |
Wide nasal bridge (HPO:0000431) | 10/16 (63%) | 22/31 (71%) | 0.555 |
Long philtrum (HPO:0000343) | 9/16 (56%) | 20/32 (63%) | 0.676 |
Low set ears (HPO:0000368) | 6/16 (38%) | 15/30 (50%) | 0.418 |
Thin upper lip (HPO:0000219) | 8/16 (50%) | 24/32 (75%) | 0.083 |
Skeletal anomalies | |||
Advanced bone age (HPO:0200001) | 2/10 (20%) | 7/15 (47%) | 0.229 |
Delayed bone age (HPO:0003799) | 7/10 (70%) | 5/15 (33%) | 0.111 |
Brachydactyly (HPO:0001156) | 8/16 (50%) | 9/29 (31%) | 0.209 |
Clinodactyly (HPO:0030084) | 4/16 (25%) | 6/28 (21%) | 1.000 |
Sacral dimple (HPO:0000960) | 4/16 (25%) | 8/25 (32%) | 0.631 |
Hairiness | |||
Thick eyebrows (HPO:0000574) | 6/16 (38%) | 23/29 (79%) | 0.005 |
Long eyelashes (HPO:0000527) | 15/16 (94%) | 24/32 (75%) | 0.239 |
Hypertrichosis, cubiti (HPO:0000998) | 7/16 (44%) | 19/31 (61%) | 0.252 |
Hypertrichosis, back (HPO:0000998) | 12/16 (75%) | 21/31 (68%) | 0.858 |
Hypertrichosis, lower limbs (HPO:0000998) | 8/16 (50%) | 9/24 (38%) | 0.433 |
Developmental and neurology | |||
Walking delay (HPO:0031936) | 10/16 (63%) | 19/31 (61%) | 0.936 |
Language delay (HP:0000750) | 12/14 (86%) | 24/30 (80%) | 0.970 |
Intellectual disability (HPO:0001249) | 14/15 (93%) | 33/33 (100%) | 0.683 |
Aggressive behavior (HPO:0000718) | 4/16 (25%) | 4/31 (13%) | 0.525 |
Organic problems | |||
Strabismus (HPO:0000486) | 3/14 (21%) | 7/32 (22%) | 1.000 |
Hyperopia (HPO:0008499) | 1/14 (7%) | 9/32 (28%) | 0.230 |
Cardiac anomaly | 3/16 (19%) | 8/22 (36%) | 0.412 |
Feeding difficulties (HPO:0011968) | 5/16 (31%) | 20/31 (65%) | 0.030 |