血小板減少症とc‐mpl遺伝子異常

  • 井原 健二
    九州大学大学院医学研究院成長発達医学 (小児科学)
  • 原 寿郎
    九州大学大学院医学研究院成長発達医学 (小児科学)

書誌事項

タイトル別名
  • Thrombocytopenia and c-mpl Gene Mutation.

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抄録

Congenital amegakaryocytic thrombocytopenia (CAMT) is a rare disorder in infancy characterized by isolated thrombocytopenia and megakaryocytopenia without physical anomalies. CAMT often progresses to bone marrow failure in later childhood, suggesting a defect in the hematopoietic stem cells as well as in the megakaryocytic lineage cells. The current studies have demonstrated that most CAMT patients suffered the disorder because of c-mpl mutation, which disrupts the function of thrombopoietin (TPO) receptor. The reported 16 types of mutations from 16 CAMT patients comprised 4 types of nonsense mutations, 4 deletions, 5 missense mutations, and 3 mutations around exon-intron junctions. Phenotype-genotype correlations were generally observed. The mutations in most patients were derived from their parents in accordance with an autosomal recessive pattern of inheritance. Many phenotypic similarities between human CAMT and murine c-mpl-deficiency were also reported. These findings confirmed the importance of TPO receptor as a development and maturation of megakaryocytic lineage and early hematopoietic progenitor cells. In the future, the analysis of the TPO receptor gene, c-mpl, in a great many patients with CAMT will help in understanding the pathophysiology of CAMT as well as its diagnosis, genetic counseling, and therapeutic judgment of the application of recombinant TPO.

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