Clinical characteristics and outcomes of chédiak-Higashi syndrome: A nationwide survey of Japan

• Published in: Pediatric blood & cancer Vol. 60; no. 10; pp. 1582 - 1586
• Main Authors: Nagai, Kozo, Ochi, Fumihiro, Terui, Kiminori, Maeda, Miho, Ohga, Shouichi, Kanegane, Hirokazu, Kitoh, Toshiyuki, Kogawa, Kazuhiro, Suzuki, Nobuhiro, Ohta, Shigeru, Ishida, Yasushi, Okamura, Takayuki, Wakiguchi, Hiroshi, Yasukawa, Masaki, Ishii, Eiichi
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2013; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Chediak-Higashi Syndrome - complications; Chediak-Higashi Syndrome - diagnosis; Chediak-Higashi Syndrome - genetics; Chediak-Higashi Syndrome - mortality; Chediak-Higashi Syndrome - pathology; Chediak-Higashi Syndrome - therapy; Child; Child, Preschool; Chédiak-Higashi syndrome; cytotoxic T lymphocyte; Data Collection; degranulation activity; Disease-Free Survival; Female; Hematology; Hematopoietic Stem Cell Transplantation; Humans; Infant; Japan - epidemiology; Lymphohistiocytosis, Hemophagocytic - diagnosis; Lymphohistiocytosis, Hemophagocytic - etiology; Lymphohistiocytosis, Hemophagocytic - genetics; Lymphohistiocytosis, Hemophagocytic - mortality; Lymphohistiocytosis, Hemophagocytic - pathology; Lymphohistiocytosis, Hemophagocytic - therapy; Lymphoma - diagnosis; Lymphoma - etiology; Lymphoma - genetics; Lymphoma - mortality; Lymphoma - pathology; lysosomal trafficking regulator (LYST) gene; Male; Oncology; Pediatrics; Retrospective Studies; Survival Rate; Transplantation, Homologous; Vesicular Transport Proteins - genetics; Japan; degranulation activity; Chédiak-Higashi syndrome; cytotoxic T lymphocyte; lysosomal trafficking regulator (LYST) gene
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.24637

Background Chédiak–Higashi syndrome (CHS) is a rare autosomal recessive disorder characterized by immunodeficiency, neurological dysfunction, and oculocutaneous albinism. Recently, several clinical CHS phenotypes have been reported. Here, we report results of a nationwide survey performed to clarify clinical characteristics and outcomes of CHS patients in Japan. Methods Questionnaires were sent to 287 institutions to collect data regarding CHS patients diagnosed between 2000 and 2010, including results of lysosomal trafficking regulator (LYST) gene analysis. Cytotoxicity and degranulation activity of cytotoxic T lymphocytes were analyzed in available patient samples. Results A total of 15 patients diagnosed with CHS were eligible for enrollment in this study. Of these, 10 (67%) had recurrent bacterial infections, five (33%) developed life‐threatening hemophagocytic lymphohistiocytosis (HLH), and one patient had complicated malignant lymphoma. Hematopoietic stem cell transplantation (HSCT) was performed for six patients including three with HLH, and 10 of the enrolled patients have survived at the time of this writing. LYST analysis was performed for 10 patients; seven different mutations were detected in seven patients, whereas no mutation was identified in three patients. Cytotoxicity and degranulation activity were impaired in patients with and without LYST mutation. Discussion Results of this survey indicate that one or two patients with CHS were newly diagnosed each year in Japan. The incidence of HLH was not as high as expected. Mutations of genes other than LYST were suspected in some cases. We conclude that determining indication for HSCT for CHS patients should be based on genetic and cytotoxic analysis. Pediatr Blood Cancer 2013;60:1582–1586. © 2013 Wiley Periodicals, Inc.