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Autoimmune lymphoproliferative syndrome

MedGen UID:
985772
Concept ID:
CN301239
Disease or Syndrome
Synonyms: ALPS; ALPS (autoimmune lymphoproliferative syndrome); autoimmune lymphoproliferative syndrome; autoimmune lymphoproliferative syndrome type 1, autosomal dominant; Canale-Smith syndrome; FAS deficiency
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).
Autosomal dominant inheritance
MedGen UID:
141047
Concept ID:
C0443147
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 heterozygotes. In the context of medical genetics, an autosomal dominant disorder is caused when a single copy of the mutant allele is present. Males and females are affected equally, and can both transmit the disorder with a risk of 50% for each child of inheriting the mutant allele.
 
Related genes: NRAS, KRAS, CASP10, CASP8, FASLG, FAS
 
Monarch Initiative: MONDO:0017979
Orphanet: ORPHA3261

Disease characteristics

Excerpted from the GeneReview: Autoimmune Lymphoproliferative Syndrome
Autoimmune lymphoproliferative syndrome (ALPS), caused by defective lymphocyte homeostasis, is characterized by the following: Non-malignant lymphoproliferation (lymphadenopathy, hepatosplenomegaly with or without hypersplenism) that often improves with age. Autoimmune disease, mostly directed toward blood cells. Lifelong increased risk for both Hodgkin and non-Hodgkin lymphoma. In ALPS-FAS (the most common and best-characterized type of ALPS, associated with heterozygous germline pathogenic variants in FAS), non-malignant lymphoproliferation typically manifests in the first years of life, inexplicably waxes and wanes, and then often decreases without treatment in the second decade of life; in many affected individuals, however, neither splenomegaly nor the overall expansion of lymphocyte subsets in peripheral blood decreases. Although autoimmunity is often not present at the time of diagnosis or at the time of the most extensive lymphoproliferation, autoantibodies can be detected before autoimmune disease manifests clinically. In ALPS-FAS caused by homozygous or compound heterozygous (biallelic) pathogenic variants in FAS, severe lymphoproliferation occurs before, at, or shortly after birth, and usually results in death at an early age. ALPS-sFAS, resulting from somatic FAS pathogenic variants in selected cell populations, notably the alpha/beta double-negative T cells (α/β-DNT cells), appears to be similar to ALPS-FAS resulting from heterozygous germline pathogenic variants in FAS, although lower incidence of splenectomy and lower lymphocyte counts have been reported in ALPS-sFAS and no cases of lymphoma have yet been published. [from GeneReviews]
Authors:
Jack JH Bleesing  |  Chinmayee B Nagaraj  |  Kejian Zhang   view full author information

Professional guidelines

PubMed

López-Nevado M, González-Granado LI, Ruiz-García R, Pleguezuelo D, Cabrera-Marante O, Salmón N, Blanco-Lobo P, Domínguez-Pinilla N, Rodríguez-Pena R, Sebastián E, Cruz-Rojo J, Olbrich P, Ruiz-Contreras J, Paz-Artal E, Neth O, Allende LM
Front Immunol 2021;12:671755. Epub 2021 Aug 10 doi: 10.3389/fimmu.2021.671755. PMID: 34447369Free PMC Article
Zhao EJ, Cheng CV, Mattman A, Chen LYC
Lancet Haematol 2021 May;8(5):e365-e375. doi: 10.1016/S2352-3026(21)00056-9. PMID: 33894171
Oliveira JB, Bleesing JJ, Dianzani U, Fleisher TA, Jaffe ES, Lenardo MJ, Rieux-Laucat F, Siegel RM, Su HC, Teachey DT, Rao VK
Blood 2010 Oct 7;116(14):e35-40. Epub 2010 Jun 10 doi: 10.1182/blood-2010-04-280347. PMID: 20538792Free PMC Article

Recent clinical studies

Etiology

Similuk MN, Yan J, Ghosh R, Oler AJ, Franco LM, Setzer MR, Kamen M, Jodarski C, DiMaggio T, Davis J, Gore R, Jamal L, Borges A, Gentile N, Niemela J, Lowe C, Jevtich K, Yu Y, Hullfish H, Hsu AP, Hong C, Littel P, Seifert BA, Milner J, Johnston JJ, Cheng X, Li Z, Veltri D, Huang K, Kaladi K, Barnett J, Zhang L, Vlasenko N, Fan Y, Karlins E, Ganakammal SR, Gilmore R, Tran E, Yun A, Mackey J, Yazhuk S, Lack J, Kuram V, Cao W, Huse S, Frank K, Fahle G, Rosenzweig S, Su Y, Hwang S, Bi W, Bennett J, Myles IA, De Ravin SS, Fuss I, Strober W, Bielekova B, Almeida de Jesus A, Goldbach-Mansky R, Williamson P, Kumar K, Dempsy C, Frischmeyer-Guerrerio P, Fisch R, Bolan H, Metcalfe DD, Komarow H, Carter M, Druey KM, Sereti I, Dropulic L, Klion AD, Khoury P, O' Connell EM, Holland-Thomas NC, Brown T, McDermott DH, Murphy PM, Bundy V, Keller MD, Peng C, Kim H, Norman S, Delmonte OM, Kang E, Su HC, Malech H, Freeman A, Zerbe C, Uzel G, Bergerson JRE, Rao VK, Olivier KN, Lyons JJ, Lisco A, Cohen JI, Lionakis MS, Biesecker LG, Xirasagar S, Notarangelo LD, Holland SM, Walkiewicz MA
J Allergy Clin Immunol 2022 Oct;150(4):947-954. Epub 2022 Jun 24 doi: 10.1016/j.jaci.2022.06.009. PMID: 35753512Free PMC Article
Neven Q, Boulanger C, Bruwier A, de Ville de Goyet M, Meyts I, Moens L, Van Damme A, Brichard B
J Clin Immunol 2021 Jan;41(1):51-58. Epub 2020 Oct 4 doi: 10.1007/s10875-020-00883-7. PMID: 33011939
Matson DR, Yang DT
Arch Pathol Lab Med 2020 Feb;144(2):245-251. Epub 2019 Apr 8 doi: 10.5858/arpa.2018-0190-RS. PMID: 30958694Free PMC Article
Kanegane H, Hoshino A, Okano T, Yasumi T, Wada T, Takada H, Okada S, Yamashita M, Yeh TW, Nishikomori R, Takagi M, Imai K, Ochs HD, Morio T
Allergol Int 2018 Jan;67(1):43-54. Epub 2017 Jul 3 doi: 10.1016/j.alit.2017.06.003. PMID: 28684198
Oliveira JB, Bleesing JJ, Dianzani U, Fleisher TA, Jaffe ES, Lenardo MJ, Rieux-Laucat F, Siegel RM, Su HC, Teachey DT, Rao VK
Blood 2010 Oct 7;116(14):e35-40. Epub 2010 Jun 10 doi: 10.1182/blood-2010-04-280347. PMID: 20538792Free PMC Article

Diagnosis

Lambert MP
Expert Rev Clin Immunol 2021 Nov;17(11):1163-1173. Epub 2021 Sep 17 doi: 10.1080/1744666X.2021.1978842. PMID: 34503378
Rieux-Laucat F, Kanellopoulos JM, Ojcius DM
Biomed J 2021 Aug;44(4):383-387. Epub 2021 Aug 23 doi: 10.1016/j.bj.2021.08.002. PMID: 34438083Free PMC Article
Zhao EJ, Cheng CV, Mattman A, Chen LYC
Lancet Haematol 2021 May;8(5):e365-e375. doi: 10.1016/S2352-3026(21)00056-9. PMID: 33894171
Matson DR, Yang DT
Arch Pathol Lab Med 2020 Feb;144(2):245-251. Epub 2019 Apr 8 doi: 10.5858/arpa.2018-0190-RS. PMID: 30958694Free PMC Article
Kanegane H, Hoshino A, Okano T, Yasumi T, Wada T, Takada H, Okada S, Yamashita M, Yeh TW, Nishikomori R, Takagi M, Imai K, Ochs HD, Morio T
Allergol Int 2018 Jan;67(1):43-54. Epub 2017 Jul 3 doi: 10.1016/j.alit.2017.06.003. PMID: 28684198

Therapy

Paskiewicz A, Niu J, Chang C
Autoimmun Rev 2023 Nov;22(11):103442. Epub 2023 Sep 6 doi: 10.1016/j.autrev.2023.103442. PMID: 37683818
Zhao EJ, Cheng CV, Mattman A, Chen LYC
Lancet Haematol 2021 May;8(5):e365-e375. doi: 10.1016/S2352-3026(21)00056-9. PMID: 33894171
Gru AA, O'Malley DP
Semin Diagn Pathol 2018 Jan;35(1):34-43. Epub 2017 Nov 28 doi: 10.1053/j.semdp.2017.11.015. PMID: 29208331
George LA, Teachey DT
Paediatr Drugs 2016 Aug;18(4):261-72. doi: 10.1007/s40272-016-0175-3. PMID: 27139496Free PMC Article
Shah S, Wu E, Rao VK, Tarrant TK
Curr Allergy Asthma Rep 2014 Sep;14(9):462. doi: 10.1007/s11882-014-0462-4. PMID: 25086580Free PMC Article

Prognosis

Maccari ME, Schneider P, Smulski CR, Meinhardt A, Pinto F, Gonzalez-Granado LI, Schuetz C, Sica MP, Gross M, Fuchs I, Kury P, Heeg M, Vocat T, Willen L, Thomas C, Hühn R, Magerus A, Lorenz M, Schwarz K, Rieux-Laucat F, Ehl S, Rensing-Ehl A
J Allergy Clin Immunol 2023 May;151(5):1391-1401.e7. Epub 2023 Jan 5 doi: 10.1016/j.jaci.2022.11.028. PMID: 36621650
López-Nevado M, González-Granado LI, Ruiz-García R, Pleguezuelo D, Cabrera-Marante O, Salmón N, Blanco-Lobo P, Domínguez-Pinilla N, Rodríguez-Pena R, Sebastián E, Cruz-Rojo J, Olbrich P, Ruiz-Contreras J, Paz-Artal E, Neth O, Allende LM
Front Immunol 2021;12:671755. Epub 2021 Aug 10 doi: 10.3389/fimmu.2021.671755. PMID: 34447369Free PMC Article
Gámez-Díaz L, Grimbacher B
Biomed J 2021 Aug;44(4):400-411. Epub 2021 Apr 19 doi: 10.1016/j.bj.2021.04.005. PMID: 34384744Free PMC Article
Costagliola G, Consolini R
Clin Exp Immunol 2021 Sep;205(3):288-305. Epub 2021 Jun 20 doi: 10.1111/cei.13620. PMID: 34008169Free PMC Article
Neven Q, Boulanger C, Bruwier A, de Ville de Goyet M, Meyts I, Moens L, Van Damme A, Brichard B
J Clin Immunol 2021 Jan;41(1):51-58. Epub 2020 Oct 4 doi: 10.1007/s10875-020-00883-7. PMID: 33011939

Clinical prediction guides

Maccari ME, Schneider P, Smulski CR, Meinhardt A, Pinto F, Gonzalez-Granado LI, Schuetz C, Sica MP, Gross M, Fuchs I, Kury P, Heeg M, Vocat T, Willen L, Thomas C, Hühn R, Magerus A, Lorenz M, Schwarz K, Rieux-Laucat F, Ehl S, Rensing-Ehl A
J Allergy Clin Immunol 2023 May;151(5):1391-1401.e7. Epub 2023 Jan 5 doi: 10.1016/j.jaci.2022.11.028. PMID: 36621650
Gámez-Díaz L, Grimbacher B
Biomed J 2021 Aug;44(4):400-411. Epub 2021 Apr 19 doi: 10.1016/j.bj.2021.04.005. PMID: 34384744Free PMC Article
Costagliola G, Consolini R
Clin Exp Immunol 2021 Sep;205(3):288-305. Epub 2021 Jun 20 doi: 10.1111/cei.13620. PMID: 34008169Free PMC Article
Kaya Z, Işık M, Oruklu N, Kirkiz S, Bağrıaçık EÜ, Allende LM, Díaz-Madroñero MJ, Ruiz-García R, Pınarlı FG, Göçün Uyar P, Koçak Ü
Turk J Haematol 2021 Jun 1;38(2):145-150. Epub 2020 Dec 30 doi: 10.4274/tjh.galenos.2020.2020.0618. PMID: 33375216Free PMC Article
Li P, Huang P, Yang Y, Hao M, Peng H, Li F
Clin Rev Allergy Immunol 2016 Feb;50(1):55-63. doi: 10.1007/s12016-015-8466-y. PMID: 25663566

Recent systematic reviews

López-Nevado M, González-Granado LI, Ruiz-García R, Pleguezuelo D, Cabrera-Marante O, Salmón N, Blanco-Lobo P, Domínguez-Pinilla N, Rodríguez-Pena R, Sebastián E, Cruz-Rojo J, Olbrich P, Ruiz-Contreras J, Paz-Artal E, Neth O, Allende LM
Front Immunol 2021;12:671755. Epub 2021 Aug 10 doi: 10.3389/fimmu.2021.671755. PMID: 34447369Free PMC Article
Hafezi N, Zaki-Dizaji M, Nirouei M, Asadi G, Sharifinejad N, Jamee M, Erfan Rasouli S, Hamedifar H, Sabzevari A, Chavoshzadeh Z, Yazdani R, Abolhassani H, Aghamohammadi A, Azizi G
Pediatr Allergy Immunol 2021 Oct;32(7):1519-1532. Epub 2021 May 27 doi: 10.1111/pai.13535. PMID: 33963613
Riaz IB, Faridi W, Patnaik MM, Abraham RS
Front Immunol 2019;10:777. Epub 2019 Apr 16 doi: 10.3389/fimmu.2019.00777. PMID: 31057537Free PMC Article
Liang Y, Zhang L, Gao J, Hu D, Ai Y
PLoS One 2012;7(5):e36698. Epub 2012 May 30 doi: 10.1371/journal.pone.0036698. PMID: 22666325Free PMC Article

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