Utility of Whole Genome Arrays for the Detection of Clinically Relevant Imbalances and Homozygosity in the Constitutional and Hematologic Malignancies Setting
Traditional chromosome analysis has been a first-tier recommended technology for both the constitutional setting of a child with intellectual disabilities or congenital anomalies as well as the hematologic setting for the patient with myeloid or lymphoid malignancies. In the constitutional setting, whole genome arrays have largely replaced traditional chromosome analysis as a first-tier test as the detection of clinically significant abnormalities has tripled with this technology over a traditional chromosome analysis. Whole genome arrays are also clinically available from multiple laboratories for detection of imbalances and stretches of homozygosity in hematologic malignancies. As we consider the value of this technology in this patient population, aspects of hematologic conditions must be considered such as mosaicism, possibility of multiple clonal populations, prevalence of clinically relevant balanced rearrangements and intragenic mutations, identification of imbalances of unknown clinical significance, and array platform design and detection limitations. This presentation will highlight the utility and challenges of this technology in both the constitutional and hematologic setting, including a discussion of compatibilities with other genetic technologies.
