Constitutional Mismatch Repair-Deficiency Syndrome Is a Rare Cause of Cancer Even in a Highly Consanguineous Population

Rong Bu, Abdul K. Siraj, Prashant Bavi, Asim Belgaumi, Shahab Uddin, Fowzan S. Alkuraya

Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 3De- partment of Pathology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Developmental Genetics Unit, Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Cancer, Riyadh, Saudi Arabia.

DOI: 10.4236/jct.2013.45114                

Abstract

Biallelic germline mutations in the mismatch repair genes, including MLH1, MSH2, MSH6 or PMS2, lead to a recessive constitutional mismatch repair-deficiency (CMMR-D) syndrome characterized by early onset malignancies in children and young adults. Because consanguinity unmasks autosomal recessive disorders, we hypothesized that the frequency of CMMR-D is inflated in the highly consanguineous population of Saudi Arabia. In this study, 371 pediatric and young adult patient samples from Saudi Arabia that cover the tumor spectrum of CMMR-D syndrome were analyzed for biallelic germline mutations in the MLH1, MSH2, MSH6 and PMS2 with the use of direct genomic sequencing. However, none of the 371 patients involved in the study was found to have biallelic pathological mutations of MLH1, MSH2, MSH6 or PMS2. This result indicates that CMMR-D is exceptionally rare among pediatric cancer patients and adult early onset cancer patients, even in the highly consanguineous Saudi population. Our findings suggest that larger cohorts will be needed, particularly in outbred populations, to determine the frequency of CMMR-D and that routine screening for this syndrome among cancer patients is not warranted.

Keywords

Constitutional Mismatch Repair-Deficiency (CMMR-D); Lynch Syndrome (LS); MLH1; MSH2; MSH6 and PMS2; Biallelic Germline Mutations

Conflicts of Interest

The authors declare no conflicts of interest.

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