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Fanconi anemia(FA)

MedGen UID:
41967
Concept ID:
C0015625
Disease or Syndrome
Synonyms: FA; Fanconi pancytopenia; Fanconi's anemia
SNOMED CT: Fanconi's hypoplastic anemia (30575002); Fanconi's familial refractory anemia (30575002); Fanconi anemia (30575002); Fanconi pancytopenia syndrome (30575002); Fanconi's anemia (30575002)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
X-linked recessive inheritance
MedGen UID:
375779
Concept ID:
C1845977
Finding
Source: Orphanet
A mode of inheritance that is observed for recessive traits related to a gene encoded on the X chromosome. In the context of medical genetics, X-linked recessive disorders manifest in males (who have one copy of the X chromosome and are thus hemizygotes), but generally not in female heterozygotes who have one mutant and one normal allele.
 
Related genes: SLX4, BRIP1, PALB2, FANCI, FANCL, RAD51C, FANCG, FANCF, FANCB, FANCE, FANCD2, FANCC, FANCA, BRCA2
 
Monarch Initiative: MONDO:0019391
OMIM® Phenotypic series: PS227650
Orphanet: ORPHA84

Disease characteristics

Excerpted from the GeneReview: Fanconi Anemia
Fanconi anemia (FA) is characterized by physical abnormalities, bone marrow failure, and increased risk for malignancy. Physical abnormalities, present in approximately 75% of affected individuals, include one or more of the following: short stature, abnormal skin pigmentation, skeletal malformations of the upper and/or lower limbs, microcephaly, and ophthalmic and genitourinary tract anomalies. Progressive bone marrow failure with pancytopenia typically presents in the first decade, often initially with thrombocytopenia or leukopenia. The incidence of acute myeloid leukemia is 13% by age 50 years. Solid tumors – particularly of the head and neck, skin, and genitourinary tract – are more common in individuals with FA. [from GeneReviews]
Authors:
Parinda A Mehta  |  Christen Ebens   view full author information

Additional description

From MedlinePlus Genetics
Fanconi anemia is a condition that affects many parts of the body. People with this condition may have bone marrow failure, physical abnormalities, organ defects, and an increased risk of certain cancers.

The major function of bone marrow is to produce new blood cells. These include red blood cells, which carry oxygen to the body's tissues; white blood cells, which fight infections; and platelets, which are necessary for normal blood clotting. Approximately 90 percent of people with Fanconi anemia have impaired bone marrow function that leads to a decrease in the production of all blood cells (aplastic anemia). Affected individuals experience extreme tiredness (fatigue) due to low numbers of red blood cells (anemia), frequent infections due to low numbers of white blood cells (neutropenia), and clotting problems due to low numbers of platelets (thrombocytopenia). People with Fanconi anemia may also develop myelodysplastic syndrome, a condition in which immature blood cells fail to develop normally.

More than half of people with Fanconi anemia have physical abnormalities. These abnormalities can involve irregular skin coloring such as unusually light-colored skin (hypopigmentation) or café-au-lait spots, which are flat patches on the skin that are darker than the surrounding area. Other possible symptoms of Fanconi anemia include malformed thumbs or forearms and other skeletal problems including short stature; malformed or absent kidneys and other defects of the urinary tract; gastrointestinal abnormalities; heart defects; eye abnormalities such as small or abnormally shaped eyes; and malformed ears and hearing loss. People with this condition may have abnormal genitalia or malformations of the reproductive system. As a result, most affected males and about half of affected females cannot have biological children (are infertile). Additional signs and symptoms can include abnormalities of the brain and spinal cord (central nervous system), including increased fluid in the center of the brain (hydrocephalus) or an unusually small head size (microcephaly).

Individuals with Fanconi anemia have an increased risk of developing a cancer of blood-forming cells in the bone marrow called acute myeloid leukemia (AML) or tumors of the head, neck, skin, gastrointestinal system, or genital tract. The likelihood of developing one of these cancers in people with Fanconi anemia is between 10 and 30 percent.  https://medlineplus.gov/genetics/condition/fanconi-anemia

Term Hierarchy

Follow this link to review classifications for Fanconi anemia in Orphanet.

Professional guidelines

PubMed

Olson TS
Hematology Am Soc Hematol Educ Program 2023 Dec 8;2023(1):556-562. doi: 10.1182/hematology.2023000489. PMID: 38066849Free PMC Article
Altintas B, Giri N, McReynolds LJ, Best A, Alter BP
Haematologica 2023 Jan 1;108(1):69-82. doi: 10.3324/haematol.2021.279981. PMID: 35417938Free PMC Article
Fiesco-Roa MO, Giri N, McReynolds LJ, Best AF, Alter BP
Blood Rev 2019 Sep;37:100589. Epub 2019 Jul 16 doi: 10.1016/j.blre.2019.100589. PMID: 31351673Free PMC Article

Curated

Fanconi Anemia Clinical Care Guidelines, Fifth Edition.

Fanconi Anemia Research Fund, Guidelines for Diagnosis and Management, 2008 (See 2020 Update)

Suggested Reading

Recent clinical studies

Etiology

Dufour C, Pierri F
Hematology Am Soc Hematol Educ Program 2022 Dec 9;2022(1):649-657. doi: 10.1182/hematology.2022000393. PMID: 36485157Free PMC Article
Peake JD, Noguchi E
Hum Genet 2022 Dec;141(12):1811-1836. Epub 2022 May 21 doi: 10.1007/s00439-022-02462-9. PMID: 35596788
Che R, Zhang J, Nepal M, Han B, Fei P
Trends Genet 2018 Mar;34(3):171-183. Epub 2017 Dec 16 doi: 10.1016/j.tig.2017.11.006. PMID: 29254745Free PMC Article
Kimble DC, Lach FP, Gregg SQ, Donovan FX, Flynn EK, Kamat A, Young A, Vemulapalli M, Thomas JW, Mullikin JC, Auerbach AD, Smogorzewska A, Chandrasekharappa SC
Hum Mutat 2018 Feb;39(2):237-254. Epub 2017 Nov 22 doi: 10.1002/humu.23366. PMID: 29098742Free PMC Article
Castella M, Pujol R, Callén E, Trujillo JP, Casado JA, Gille H, Lach FP, Auerbach AD, Schindler D, Benítez J, Porto B, Ferro T, Muñoz A, Sevilla J, Madero L, Cela E, Beléndez C, de Heredia CD, Olivé T, de Toledo JS, Badell I, Torrent M, Estella J, Dasí A, Rodríguez-Villa A, Gómez P, Barbot J, Tapia M, Molinés A, Figuera A, Bueren JA, Surrallés J
Blood 2011 Apr 7;117(14):3759-69. Epub 2011 Jan 27 doi: 10.1182/blood-2010-08-299917. PMID: 21273304Free PMC Article

Diagnosis

Dufour C, Pierri F
Hematology Am Soc Hematol Educ Program 2022 Dec 9;2022(1):649-657. doi: 10.1182/hematology.2022000393. PMID: 36485157Free PMC Article
Fiesco-Roa MO, Giri N, McReynolds LJ, Best AF, Alter BP
Blood Rev 2019 Sep;37:100589. Epub 2019 Jul 16 doi: 10.1016/j.blre.2019.100589. PMID: 31351673Free PMC Article
Castella M, Pujol R, Callén E, Trujillo JP, Casado JA, Gille H, Lach FP, Auerbach AD, Schindler D, Benítez J, Porto B, Ferro T, Muñoz A, Sevilla J, Madero L, Cela E, Beléndez C, de Heredia CD, Olivé T, de Toledo JS, Badell I, Torrent M, Estella J, Dasí A, Rodríguez-Villa A, Gómez P, Barbot J, Tapia M, Molinés A, Figuera A, Bueren JA, Surrallés J
Blood 2011 Apr 7;117(14):3759-69. Epub 2011 Jan 27 doi: 10.1182/blood-2010-08-299917. PMID: 21273304Free PMC Article
Auerbach AD
Mutat Res 2009 Jul 31;668(1-2):4-10. Epub 2009 Feb 28 doi: 10.1016/j.mrfmmm.2009.01.013. PMID: 19622403Free PMC Article
Green AM, Kupfer GM
Hematol Oncol Clin North Am 2009 Apr;23(2):193-214. doi: 10.1016/j.hoc.2009.01.008. PMID: 19327579Free PMC Article

Therapy

Dufour C, Pierri F
Hematology Am Soc Hematol Educ Program 2022 Dec 9;2022(1):649-657. doi: 10.1182/hematology.2022000393. PMID: 36485157Free PMC Article
Reiss KA, Mick R, O'Hara MH, Teitelbaum U, Karasic TB, Schneider C, Cowden S, Southwell T, Romeo J, Izgur N, Hannan ZM, Tondon R, Nathanson K, Vonderheide RH, Wattenberg MM, Beatty G, Domchek SM
J Clin Oncol 2021 Aug 1;39(22):2497-2505. Epub 2021 May 10 doi: 10.1200/JCO.21.00003. PMID: 33970687
O'Reilly EM, Lee JW, Zalupski M, Capanu M, Park J, Golan T, Tahover E, Lowery MA, Chou JF, Sahai V, Brenner R, Kindler HL, Yu KH, Zervoudakis A, Vemuri S, Stadler ZK, Do RKG, Dhani N, Chen AP, Kelsen DP
J Clin Oncol 2020 May 1;38(13):1378-1388. Epub 2020 Jan 24 doi: 10.1200/JCO.19.02931. PMID: 31976786Free PMC Article
Ramus SJ, Song H, Dicks E, Tyrer JP, Rosenthal AN, Intermaggio MP, Fraser L, Gentry-Maharaj A, Hayward J, Philpott S, Anderson C, Edlund CK, Conti D, Harrington P, Barrowdale D, Bowtell DD, Alsop K, Mitchell G; AOCS Study Group, Cicek MS, Cunningham JM, Fridley BL, Alsop J, Jimenez-Linan M, Poblete S, Lele S, Sucheston-Campbell L, Moysich KB, Sieh W, McGuire V, Lester J, Bogdanova N, Dürst M, Hillemanns P; Ovarian Cancer Association Consortium, Odunsi K, Whittemore AS, Karlan BY, Dörk T, Goode EL, Menon U, Jacobs IJ, Antoniou AC, Pharoah PD, Gayther SA
J Natl Cancer Inst 2015 Nov;107(11) Epub 2015 Aug 27 doi: 10.1093/jnci/djv214. PMID: 26315354Free PMC Article
Green AM, Kupfer GM
Hematol Oncol Clin North Am 2009 Apr;23(2):193-214. doi: 10.1016/j.hoc.2009.01.008. PMID: 19327579Free PMC Article

Prognosis

Malouf C, Loughran SJ, Wilkinson AC, Shimamura A, Río P
Exp Hematol 2022 Jan;105:18-21. Epub 2021 Nov 18 doi: 10.1016/j.exphem.2021.11.004. PMID: 34801643Free PMC Article
Nguyen L, W M Martens J, Van Hoeck A, Cuppen E
Nat Commun 2020 Nov 4;11(1):5584. doi: 10.1038/s41467-020-19406-4. PMID: 33149131Free PMC Article
Kimble DC, Lach FP, Gregg SQ, Donovan FX, Flynn EK, Kamat A, Young A, Vemulapalli M, Thomas JW, Mullikin JC, Auerbach AD, Smogorzewska A, Chandrasekharappa SC
Hum Mutat 2018 Feb;39(2):237-254. Epub 2017 Nov 22 doi: 10.1002/humu.23366. PMID: 29098742Free PMC Article
Nepal M, Che R, Zhang J, Ma C, Fei P
Trends Cancer 2017 Dec;3(12):840-856. Epub 2017 Nov 10 doi: 10.1016/j.trecan.2017.10.005. PMID: 29198440Free PMC Article
Decker B, Allen J, Luccarini C, Pooley KA, Shah M, Bolla MK, Wang Q, Ahmed S, Baynes C, Conroy DM, Brown J, Luben R, Ostrander EA, Pharoah PD, Dunning AM, Easton DF
J Med Genet 2017 Nov;54(11):732-741. Epub 2017 Aug 4 doi: 10.1136/jmedgenet-2017-104588. PMID: 28779002Free PMC Article

Clinical prediction guides

Rogers CB, Kram RE, Lin K, Myers CL, Sobeck A, Hendrickson EA, Bielinsky AK
Cell Rep 2023 May 30;42(5):112428. Epub 2023 Apr 21 doi: 10.1016/j.celrep.2023.112428. PMID: 37086407Free PMC Article
Kimble DC, Lach FP, Gregg SQ, Donovan FX, Flynn EK, Kamat A, Young A, Vemulapalli M, Thomas JW, Mullikin JC, Auerbach AD, Smogorzewska A, Chandrasekharappa SC
Hum Mutat 2018 Feb;39(2):237-254. Epub 2017 Nov 22 doi: 10.1002/humu.23366. PMID: 29098742Free PMC Article
Ramus SJ, Song H, Dicks E, Tyrer JP, Rosenthal AN, Intermaggio MP, Fraser L, Gentry-Maharaj A, Hayward J, Philpott S, Anderson C, Edlund CK, Conti D, Harrington P, Barrowdale D, Bowtell DD, Alsop K, Mitchell G; AOCS Study Group, Cicek MS, Cunningham JM, Fridley BL, Alsop J, Jimenez-Linan M, Poblete S, Lele S, Sucheston-Campbell L, Moysich KB, Sieh W, McGuire V, Lester J, Bogdanova N, Dürst M, Hillemanns P; Ovarian Cancer Association Consortium, Odunsi K, Whittemore AS, Karlan BY, Dörk T, Goode EL, Menon U, Jacobs IJ, Antoniou AC, Pharoah PD, Gayther SA
J Natl Cancer Inst 2015 Nov;107(11) Epub 2015 Aug 27 doi: 10.1093/jnci/djv214. PMID: 26315354Free PMC Article
Lubinsky M
Am J Med Genet A 2015 Nov;167A(11):2594-8. Epub 2015 Jul 21 doi: 10.1002/ajmg.a.37257. PMID: 26198446
Castella M, Pujol R, Callén E, Trujillo JP, Casado JA, Gille H, Lach FP, Auerbach AD, Schindler D, Benítez J, Porto B, Ferro T, Muñoz A, Sevilla J, Madero L, Cela E, Beléndez C, de Heredia CD, Olivé T, de Toledo JS, Badell I, Torrent M, Estella J, Dasí A, Rodríguez-Villa A, Gómez P, Barbot J, Tapia M, Molinés A, Figuera A, Bueren JA, Surrallés J
Blood 2011 Apr 7;117(14):3759-69. Epub 2011 Jan 27 doi: 10.1182/blood-2010-08-299917. PMID: 21273304Free PMC Article

Recent systematic reviews

Santana NCM, de Sena ACVP, Rocha PADS, de Arruda JAA, Torres-Pereira CC, Abreu LG, Fournier BPJ, Warnakulasuriya S, Silva TA
Oral Oncol 2024 Mar;150:106699. Epub 2024 Feb 3 doi: 10.1016/j.oraloncology.2024.106699. PMID: 38309198
Chamseddine RS, Wang C, Yin K, Wang J, Singh P, Zhou J, Robson ME, Braun D, Hughes KS
Breast Cancer Res Treat 2022 Jan;191(1):31-38. Epub 2021 Oct 13 doi: 10.1007/s10549-021-06413-2. PMID: 34642874
Lee RH, Kang H, Yom SS, Smogorzewska A, Johnson DE, Grandis JR
Clin Cancer Res 2021 Oct 1;27(19):5168-5187. doi: 10.1158/1078-0432.CCR-21-1259. PMID: 34045293Free PMC Article
Shafqat S, Tariq E, Parnes AD, Dasouki MJ, Ahmed SO, Hashmi SK
Hematol Oncol Stem Cell Ther 2021 Dec;14(4):290-301. Epub 2021 Mar 7 doi: 10.1016/j.hemonc.2021.02.001. PMID: 33736979
Nicoletti E, Rao G, Bueren JA, Río P, Navarro S, Surrallés J, Choi G, Schwartz JD
Ann Hematol 2020 May;99(5):913-924. Epub 2020 Feb 17 doi: 10.1007/s00277-020-03954-2. PMID: 32065290Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • FARF, 2020
      Fanconi Anemia Clinical Care Guidelines, Fifth Edition.
    • FARF, 2008
      Fanconi Anemia Research Fund, Guidelines for Diagnosis and Management, 2008 (See 2020 Update)

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