Collect

Skin biopsy or two T25 flasks of cultured fibroblasts from skin* 
Blood – 2-3 mL in an EDTA (purple top) tube. 
Bone Marrow - 2-3 mL in an EDTA (purple top) tube. 
Saliva – please contact the lab regarding the availability of collection kits by emailing DGDGeneticCounselor@chop.edu.
DNA – 3 ug of DNA with a concentration of at least 50 ng/ul

*If the individual being tested has suspected or confirmed myelodysplasia or leukemia/lymphoma, or if the individual is the recipient of a donor (allogenic) bone marrow transplant, cultured fibroblasts from skin are the preferred specimen to assess for constitutional genetic variants. 

Specimen Preparation

Please provide detailed clinical history and features. For more information contact the lab at 6-1447 or by sending an email to DGDGeneticCounselor@chop.edu.

Unacceptable Conditions

Heparinized specimens, severely hemolyzed specimens, frozen, clotted or possibly commingled specimens, blood in non-sterile or leaky containers, mislabeled or inappropriately labeled specimens.

Storage/Transport Temperature

For CHOP Phlebotomy: Samples can be collected throughout the week. Samples collected on weekends or holidays are held in Central Labs and sent to the Genomic Diagnostic Lab the following business day. 

For External Clients: Refrigerate sample until shipment. Send the sample at room temperature with overnight delivery for receipt Monday through Friday, optimally within 24 hours of collection.

Please contact the lab (267-426-1447) with questions regarding non-blood specimens.

Volume Required

2-3 mL of blood or 3 ug of DNA with a concentration of at least 50 ng/ul

Minimum Required

1 mL of whole blood

Phlebotomy Draw

Yes

Clinical Features

Clinical symptoms of inherited neutropenia include recurrent infections and fevers, inflammation of skin and gums, osteopenia and leukemia. 

Performing Lab

Division of Genomic Diagnostics

Performed

Monday-Friday 9:00am - 4:00pm

Reported

28 days

Detection Rate

The diagnostic yield for comprehensive NGS panels is not yet well-established, and depends on the panel's gene content and the patient's clinical features. Estimated detection rates are provided for pathogenic variants in the genes on this panel that can be identified by gene sequencing for probands meeting the clinical diagnostic criteria for specific disorders:

Congenital Neutropenia: ~38-80% associated with ELANE pathogenic variants [PMID: 20301705]
Barth syndrome: >95% [PMID: 25299040]
Cartilage-hair hypoplasia: >95% [PMID: 17189938]
Chediak-Higashi syndrome: ~90% [PMID: 20301751]
Cohen syndrome: >95% [PMID: 21330571, 19006247]
G6PC3 deficiency: ~43% [PMID: 25879134]
Glycogen Storage Disease Type 1b: >95% [PMID: 20301489]
Hermansky-Pudlak syndrome: ~11% [PMID: 20301464]
Shwachman-Diamond syndrome: >90% [PMID: 20301722]
Wiskott-Aldrich syndrome: >95% [PMID: 20301357]

Utility

There are many syndromes associated with inherited neutropenia with phenotypic overlap; therefore, a genetic diagnosis is beneficial for management options [Donadieu 2011, PMID: 21595885].

Synonyms

  • AP3B1, CSF3R, CXCR4, ELANE, G6PC3, GATA1, GATA2, GFI1, HAX1, LAMTOR2, LYST, RAB27A, RAC2, RMRP, SBDS, SLC37A4, TAFAZZIN, USB1, VPS13B, VPS45, WAS, WIPF1
  • INEUX

LIS Mnemonic

INEUX 

Available STAT

Yes

Test Notes

Genomic DNA was extracted from patient tissue following standard DNA extraction protocols. Whole genome sequencing was performed on the Illumina NovaSeq 6000 platform using the Illumina DNA PCR-Free Library Prep with 150bp paired-end reads. Mapping and analysis were based on the GRCh38 reference sequence. Sequencing data was processed using the Dragen pipeline (Illumina) to call both sequence and copy number variants.

Molecular Testing Notes

The inherited neutropenia panel includes analysis of the following genes: AP3B1, CSF3R, CXCR4*, ELANE*, G6PC3, GATA1, GATA2, GFI1*, HAX1, LAMTOR2, LYST, RAB27A, RAC2*, RMRP, SBDS, SLC37A4, TAFAZZIN, USB1, VPS13B, VPS45, WAS, WIPF1                                                                                                                                                                                                                    
* Sequence analysis only is performed for these genes.   
 

CPT Codes

81406x3, 81408, 81479
Collection

Collect

Skin biopsy or two T25 flasks of cultured fibroblasts from skin* 
Blood – 2-3 mL in an EDTA (purple top) tube. 
Bone Marrow - 2-3 mL in an EDTA (purple top) tube. 
Saliva – please contact the lab regarding the availability of collection kits by emailing DGDGeneticCounselor@chop.edu.
DNA – 3 ug of DNA with a concentration of at least 50 ng/ul

*If the individual being tested has suspected or confirmed myelodysplasia or leukemia/lymphoma, or if the individual is the recipient of a donor (allogenic) bone marrow transplant, cultured fibroblasts from skin are the preferred specimen to assess for constitutional genetic variants. 

Specimen Preparation

Please provide detailed clinical history and features. For more information contact the lab at 6-1447 or by sending an email to DGDGeneticCounselor@chop.edu.

Unacceptable Conditions

Heparinized specimens, severely hemolyzed specimens, frozen, clotted or possibly commingled specimens, blood in non-sterile or leaky containers, mislabeled or inappropriately labeled specimens.

Storage/Transport Temperature

For CHOP Phlebotomy: Samples can be collected throughout the week. Samples collected on weekends or holidays are held in Central Labs and sent to the Genomic Diagnostic Lab the following business day. 

For External Clients: Refrigerate sample until shipment. Send the sample at room temperature with overnight delivery for receipt Monday through Friday, optimally within 24 hours of collection.

Please contact the lab (267-426-1447) with questions regarding non-blood specimens.

Volume Required

2-3 mL of blood or 3 ug of DNA with a concentration of at least 50 ng/ul

Minimum Required

1 mL of whole blood

Phlebotomy Draw

Yes
Ordering

Clinical Features

Clinical symptoms of inherited neutropenia include recurrent infections and fevers, inflammation of skin and gums, osteopenia and leukemia. 

Performing Lab

Division of Genomic Diagnostics

Performed

Monday-Friday 9:00am - 4:00pm

Reported

28 days

Detection Rate

The diagnostic yield for comprehensive NGS panels is not yet well-established, and depends on the panel's gene content and the patient's clinical features. Estimated detection rates are provided for pathogenic variants in the genes on this panel that can be identified by gene sequencing for probands meeting the clinical diagnostic criteria for specific disorders:

Congenital Neutropenia: ~38-80% associated with ELANE pathogenic variants [PMID: 20301705]
Barth syndrome: >95% [PMID: 25299040]
Cartilage-hair hypoplasia: >95% [PMID: 17189938]
Chediak-Higashi syndrome: ~90% [PMID: 20301751]
Cohen syndrome: >95% [PMID: 21330571, 19006247]
G6PC3 deficiency: ~43% [PMID: 25879134]
Glycogen Storage Disease Type 1b: >95% [PMID: 20301489]
Hermansky-Pudlak syndrome: ~11% [PMID: 20301464]
Shwachman-Diamond syndrome: >90% [PMID: 20301722]
Wiskott-Aldrich syndrome: >95% [PMID: 20301357]

Utility

There are many syndromes associated with inherited neutropenia with phenotypic overlap; therefore, a genetic diagnosis is beneficial for management options [Donadieu 2011, PMID: 21595885].

Synonyms

  • AP3B1, CSF3R, CXCR4, ELANE, G6PC3, GATA1, GATA2, GFI1, HAX1, LAMTOR2, LYST, RAB27A, RAC2, RMRP, SBDS, SLC37A4, TAFAZZIN, USB1, VPS13B, VPS45, WAS, WIPF1
  • INEUX

LIS Mnemonic

INEUX 

Available STAT

Yes

Test Notes

Genomic DNA was extracted from patient tissue following standard DNA extraction protocols. Whole genome sequencing was performed on the Illumina NovaSeq 6000 platform using the Illumina DNA PCR-Free Library Prep with 150bp paired-end reads. Mapping and analysis were based on the GRCh38 reference sequence. Sequencing data was processed using the Dragen pipeline (Illumina) to call both sequence and copy number variants.

Molecular Testing Notes

The inherited neutropenia panel includes analysis of the following genes: AP3B1, CSF3R, CXCR4*, ELANE*, G6PC3, GATA1, GATA2, GFI1*, HAX1, LAMTOR2, LYST, RAB27A, RAC2*, RMRP, SBDS, SLC37A4, TAFAZZIN, USB1, VPS13B, VPS45, WAS, WIPF1                                                                                                                                                                                                                    
* Sequence analysis only is performed for these genes.   
 
Result Interpretation
Administrative

CPT Codes

81406x3, 81408, 81479