Bloom's Syndrome via the BLM Gene

Summary and Pricing

Test Method

Sequencing and CNV Detection via NextGen Sequencing using PG-Select Capture Probes
Test Code Test Copy GenesTest CPT Code Gene CPT Codes Copy CPT Codes Base Price
3089 BLM 81479 81479,81479 $640 Order Options and Pricing
Test Code Test Copy Genes Test CPT Code Gene CPT Codes Copy CPT Code Base Price
3089BLM81479 81479 $640 Order Options and Pricing

Pricing Comments

This test is also offered via our exome backbone with CNV detection (click here). The exome-based test may be higher priced, but permits reflex to the entire exome or to any other set of clinically relevant genes.

A 25% additional charge will be applied to STAT orders. View STAT turnaround times here.

Targeted Testing

For ordering sequencing of targeted known variants, go to our Targeted Variants page.

Turnaround Time

18 days on average

EMAIL CONTACTS

Genetic Counselors

Geneticist

Clinical Features and Genetics

Clinical Features

Bloom’s syndrome (BS; OMIM 210900) was first described in 1954 as a “congenital” skin disorder in “dwarfs” (Bloom Am J Dis Child 88:754-758, 1954). While patients were found to have additional clinical features, such as immune deficiencies and a propensity for cancer (German et al. Science 148:506-507, 1965; German Am J Hum Genet 21-196-227, 1969), sun-sensitive facial lesions, low birth weight and stunted growth remain the most consistent features of Bloom’s syndrome today. Symptoms of BS are related to increased mutability of proliferating somatic cells, particularly epithelial cells and lymphocytes. When grown in culture and viewed microscopically, cells of BS patients exhibit extensive “chromosome breakage”, including gaps and breaks, structural rearrangements, and telomeric associations (German and Crippa Ann Genet 9143-154, 1966). Chromosome breakage ultimately leads to excessive somatic recombination and high variant rates (Groden and German Hum Genet 90:360-367, 1992). About one-third of individuals with BS die by the age of 30 due to complications of cancer or from chronic lung disease as a result of immune deficiency (German Cancer Genet Cytogenet 93:100-106, 1997).

Genetics

Bloom’s syndrome is an autosomal recessive disorder, caused by homozygous or compound heterozygous variants in the BLM gene (German et al. Hum Mutat 28:743-753, 2007); more than 60 unique variants have been identified. Most (60%) are single nucleotide changes leading to nonsense, missense, or splicing variants, while the remaining are small insertions or deletions (35%) or large deletions of multiple exons (5%). The BLM gene encodes a DNA helicase of the RecQ family. RecQ proteins are critical for maintaining the efficiency and integrity of DNA replication (Hickson Nat Rev Cancer 3:169-178, 2003); they resolve secondary structures ahead of replication forks, limit recombination to identical sequences, and assist in the replication and maintenance of telomeres (Bennett and Keck Crit Rev Biochem Mol Biol 39:79-97, 2004). In addition to these cellular functions, the BLM protein may also be important for the mismatch repair (MMR) pathway through its interaction with the MLH1 and MSH6 proteins (Langland et al. J Biol Chem 276:30031-30035, 2001; Pedrazzi et al. Biol Chem 384:1155-1164, 2003). Indeed, there is some evidence that heterozygous carriers of a BLM variant have an increased risk for colorectal cancer (Gruber et al. Science 297:2013, 2002), a disease most commonly associated with heterozygous variants in the MMR genes MLH1, MSH2 and MSH6.

Testing Strategy

This test provides full coverage of all coding exons of the BLM gene, plus ~10 bases of flanking noncoding DNA. We define full coverage as >20X NGS reads or Sanger sequencing.

Clinical Sensitivity - Sequencing with CNV PG-Select

In a retrospective study (German et al. Hum Mutat 28(8): 743-53, 2007), 87% of patients diagnosed with Bloom’s syndrome were reported to have two BLM variants. In 6% of the patients, only one variant was found for this recessive disease, indicating the second variant was not detectable by DNA sequencing methods.

Gross deletions of multiple exons account for approximately 5% of BLM cases.

Indications for Test

Candidates for this test are patients diagnosed with Bloom’s syndrome. This test is specifically designed for heritable germline variants and is not appropriate for the detection of somatic variants in tumor tissue. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in BLM.

Gene

Official Gene Symbol OMIM ID
BLM 604610
Inheritance Abbreviation
Autosomal Dominant AD
Autosomal Recessive AR
X-Linked XL
Mitochondrial MT

Disease

Name Inheritance OMIM ID
Bloom Syndrome AR 210900

Citations

  • Bennett RJ, Keck JL. 2004. Structure and function of RecQ DNA helicases. Crit. Rev. Biochem. Mol. Biol. 39: 79-97. PubMed ID: 15217989
  • Bloom, D. 1954. Congenital telangiectatic erythema resembling lupus erythematosus in dwarfs; probably a syndrome entity. AMA Am J Dis Child 88(6): 754-8. PubMed ID: 13206391
  • German and Crippa Ann Genet 9143-154, 1966
  • German J, Sanz MM, Ciocci S, Ye TZ, Ellis NA. 2007. Syndrome-causing mutations of the BLM gene in persons in the Bloom’s Syndrome Registry. Human Mutation 28: 743–753. PubMed ID: 17407155
  • German, J. (1997). "Bloom's syndrome. XX. The first 100 cancers." Cancer Genet Cytogenet 93(1): 100-6. PubMed ID: 9062585
  • German, J. 1969. Bloom's syndrome. I. Genetical and clinical observations in the first twenty-seven patients. Am J Hum Genet 21(2): 196-227. PubMed ID: 5770175
  • German, J., et.al. 1965. Chromosomal Breakage in a Rare and Probably Genetically Determined Syndrome of Man. Science 148: 506-7. PubMed ID: 14263770
  • Groden, J., German, J. (1992). "Bloom's syndrome. XVIII. Hypermutability at a tandem-repeat locus." Hum Genet 90(4): 360-7. PubMed ID: 1483691
  • Gruber SB, Ellis NA, Scott KK, Almog R, Kolachana P, Bonner JD, Kirchhoff T, Tomsho LP, Nafa K, Pierce H, Low M, Satagopan J, et al. 2002. BLM heterozygosity and the risk of colorectal cancer. Science 297: 2013.. PubMed ID: 12242432
  • Hickson ID. 2003. RecQ helicases: caretakers of the genome. Nature Reviews Cancer 3: 169–178. PubMed ID: 12612652
  • Langland G. 2001. The Bloom’s Syndrome Protein (BLM) Interacts with MLH1 but Is Not Required for DNA Mismatch Repair. Journal of Biological Chemistry 276: 30031–30035. PubMed ID: 11325959
  • Pedrazzi G, Bachrati CZ, Selak N, Studer I, Petkovic M, Hickson ID, Jiricny J, Stagljar I. 2003. The Bloom’s syndrome helicase interacts directly with the human DNA mismatch repair protein hMSH6. Biol. Chem. 384: 1155–1164. PubMed ID: 12974384

Ordering/Specimens

Ordering Options

We offer several options when ordering sequencing tests. For more information on these options, see our Ordering Instructions page. To view available options, click on the Order Options button within the test description.

myPrevent - Online Ordering

  • The test can be added to your online orders in the Summary and Pricing section.
  • Once the test has been added log in to myPrevent to fill out an online requisition form.

Requisition Form

  • A completed requisition form must accompany all specimens.
  • Billing information along with specimen and shipping instructions are within the requisition form.
  • All testing must be ordered by a qualified healthcare provider.

For Requisition Forms, visit our Forms page


Specimen Types

Specimen Requirements and Shipping Details

loading Loading... ×

ORDER OPTIONS

View Ordering Instructions

1) Select Test Type


2) Select Additional Test Options

STAT and Prenatal Test Options are not available with Patient Plus.

No Additional Test Options are available for this test.

Total Price: $
×
Copy Text to Clipboard
×