The impact of clinical genome sequencing in a global population with suspected rare genetic disease

被引:7
作者
Thorpe, Erin [1 ,40 ]
Williams, Taylor [2 ]
Shaw, Chad [2 ,3 ,4 ]
Chekalin, Evgenii [1 ]
Ortega, Julia [1 ,5 ]
Robinson, Keisha [1 ]
Button, Jason [1 ]
Jones, Marilyn C. [6 ,7 ]
del Campo, Miguel [6 ,7 ]
Basel, Donald [8 ]
McCarrier, Julie [8 ]
Keppen, Laura Davis [9 ]
Royer, Erin [10 ]
Foster-Bonds, Romina [11 ]
Duenas-Roque, Milagros M. [12 ]
Urraca, Nora [13 ]
Bosfield, Kerri [13 ]
Brown, Chester W. [13 ]
Lydigsen, Holly [13 ]
Mroczkowski, Henry J. [13 ]
Ward, Jewell [13 ]
Sirchia, Fabio [14 ,15 ]
Giorgio, Elisa [14 ,16 ]
Vaux, Keith [17 ]
Salguero, Hildegard Pena [18 ]
Lumaka, Aime [19 ,20 ]
Mubungu, Gerrye [19 ]
Makay, Prince [19 ]
Ngole, Mamy [19 ]
Lukusa, Prosper Tshilobo [19 ]
Vanderver, Adeline [21 ,22 ]
Muirhead, Kayla [23 ]
Sherbini, Omar [21 ]
Lah, Melissa D. [24 ]
Anderson, Katelynn [24 ]
Bazalar-Montoya, Jeny [25 ]
Rodriguez, Richard S. [25 ]
Cornejo-Olivas, Mario [26 ,27 ]
Milla-Neyra, Karina [26 ]
Shinawi, Marwan [28 ,29 ]
Magoulas, Pilar [30 ]
Henry, Duncan [31 ]
Gibson, Kate [32 ]
Wiafe, Samuel [33 ]
Jayakar, Parul [34 ]
Salyakina, Daria [34 ]
Masser-Frye, Diane [6 ,35 ]
Serize, Arturo [36 ]
Perez, Jorge E. [36 ]
Taylor, Alan [37 ]
机构
[1] Illumina Inc, San Diego, CA 92122 USA
[2] Genet & Genom Serv PBC, Houston, TX USA
[3] Baylor Coll Med, Dept Mol & Human Genet, Houston, TX USA
[4] Rice Univ, Dept Stat, Houston, TX USA
[5] C2N Diagnost, St Louis, MO USA
[6] Rady Childrens Hosp, San Diego, CA USA
[7] Univ Calif San Diego, San Diego, CA USA
[8] Med Coll Wisconsin, Dept Pediat, Milwaukee, WI USA
[9] Sanford USD Med Ctr, Sioux Falls, SD USA
[10] USD Sanford Sch Med, Sanford Childrens Specialty Clin, Sanford Hlth, Sioux Falls, SD USA
[11] Rare Genom Inst, Los Angeles, CA USA
[12] Hosp Edgardo Rebagliati Martins EsSalud, Serv Genet, Lima, Peru
[13] Univ Tennessee, Bonheur Childrens Hosp, Hlth Sci Ctr, Memphis, TN USA
[14] Univ Pavia, Dept Mol Med, Pavia, Italy
[15] IRCCS San Matteo Fdn, Med Genet Unit, Pavia, Italy
[16] IRCCS Mondino Fdn, Med Genet Unit, Pavia, Italy
[17] Point Loma Pediat, San Diego, CA USA
[18] Padrino Childrens Fdn, Todos Santos, BCS, Mexico
[19] Univ Kinshasa, Ctr Genet Humaine, Kinshasa, DEM REP CONGO
[20] Ctr Human Genet, CHU, Liege, Belgium
[21] Childrens Hosp Philadelphia, Dept Pediat, Div Neurol, Philadelphia, PA USA
[22] Univ Penn, Perelman Sch Med, Dept Neurol, Philadelphia, PA USA
[23] Ambry Genet, Aliso Viejo, CA USA
[24] Indiana Univ Sch Med, Indianapolis, IN USA
[25] Inst Nacl Salud Nino San Borja, Lima, Peru
[26] Inst Nacl Ciencias Neurol, Neurogenet Res Ctr, Lima, Peru
[27] Univ Cient Sur, Neurogenet Working Grp, Lima, Peru
[28] Washington Univ, St Louis, MO USA
[29] St Louis Childrens Hosp, St Louis, MO USA
[30] Texas Childrens Hosp, Houston, TX USA
[31] UCSF Benioff Childrens Hosp, San Francisco, CA USA
[32] Canterbury Dist Hlth Board, Canterbury, New Zealand
[33] Rare Dis Ghana Initiat, Accra, Ghana
[34] Nicklaus Childrens Hlth Syst, Miami, FL USA
[35] San Diego Imperial Cty Dev Serv Inc, San Diego, CA USA
[36] South Miami Hosp, South Miami, FL USA
[37] Al Jalila Childrens Specialty Hosp, Al Jalila Genom Ctr Excellence, Dubai, U Arab Emirates
[38] Mohammed Bin Rashid Univ Med & Hlth Sci, Ctr Genom Discovery, Dubai, U Arab Emirates
[39] Veracyte, San Diego, CA USA
[40] Genet Alliance, Damascus, MD 20872 USA
关键词
RECOMMENDATIONS; EXOME;
D O I
10.1016/j.ajhg.2024.05.006
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
There is mounting evidence of the value of clinical genome sequencing (cGS) in individuals with suspected rare genetic disease (RGD), but cGS performance and impact on clinical care in a diverse population drawn from both high-income countries (HICs) and low- and middle-income countries (LMICs) has not been investigated. The iHope program, a philanthropic cGS initiative, established a network of 24 clinical sites in eight countries through which it provided cGS to individuals with signs or symptoms of an RGD and constrained access to molecular testing. A total of 1,004 individuals (median age, 6.5 years; 53.5% male) with diverse ancestral backgrounds (51.8% non-majority European) were assessed from June 2016 to September 2021. The diagnostic yield of cGS was 41.4% (416/1,004), with individuals from LMIC sites 1.7 times more likely to receive a positive test result compared to HIC sites (LMIC 56.5% [195/345] vs. HIC 33.5% [221/659], OR 2.6, 95% CI 1.9-3.4, p < 0.0001). A change in diagnostic evaluation occurred in 76.9% (514/668) of individuals. Change of management, inclusive of specialty referrals, imaging and testing, therapeutic interventions, and palliative care, was reported in 41.4% (285/694) of individuals, which increased to 69.2% (480/694) when genetic counseling and avoidance of additional testing were also included. Individuals from LMIC sites were as likely as their HIC counterparts to experience a change in diagnostic evaluation (OR 6.1, 95% CI 1.1-infinity, p = 0.05) and change of management (OR 0.9, 95% CI 0.5-1.3, p = 0.49). Increased access to genomic testing may support diagnostic equity and the reduction of global health care disparities.
引用
收藏
页码:1271 / 1281
页数:12
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