{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:55:07Z","timestamp":1792616107596,"version":"4.5.0"},"reference-count":31,"publisher":"American Society of Hematology","issue":"14","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Germ line variants in the DDX41 gene have been linked to myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) development. However, the risks associated with different variants remain unknown, as do the basis of their leukemogenic properties, impact on steady-state hematopoiesis, and links to other cancers. Here, we investigate the frequency and significance of DDX41 variants in 454\u2009792 United Kingdom Biobank (UKB) participants and identify 452 unique nonsynonymous DNA variants in 3538 (1\/129) individuals. Many were novel, and the prevalence of most varied markedly by ancestry. Among the 1059 individuals with germ line pathogenic variants (DDX41-GPV) 34 developed MDS\/AML (odds ratio, 12.3 vs noncarriers). Of these, 7 of 218 had start-lost, 22 of 584 had truncating, and 5 of 257 had missense (odds ratios: 12.9, 15.1, and 7.5, respectively). Using multivariate logistic regression, we found significant associations of DDX41-GPV with MDS, AML, and family history of leukemia but not lymphoma, myeloproliferative neoplasms, or other cancers. We also report that DDX41-GPV carriers do not have an increased prevalence of clonal hematopoiesis (CH). In fact, CH was significantly more common before sporadic vs DDX41-mutant MDS\/AML, revealing distinct evolutionary paths. Furthermore, somatic mutation rates did not differ between sporadic and DDX41-mutant AML genomes, ruling out genomic instability as a driver of the latter. Finally, we found that higher mean red cell volume (MCV) and somatic DDX41 mutations in blood DNA identify DDX41-GPV carriers at increased MDS\/AML risk. Collectively, our findings give new insights into the prevalence and cognate risks associated with DDX41 variants, as well as the clonal evolution and early detection of DDX41-mutant MDS\/AML.<\/jats:p>","DOI":"10.1182\/blood.2023020209","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T16:00:38Z","timestamp":1690560038000},"page":"1185-1192","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":56,"title":["Prevalence and significance of\n                    <i>DDX41<\/i>\n                    gene variants in the general population"],"prefix":"10.1182","volume":"142","author":[{"given":"Sruthi","family":"Cheloor Kovilakam","sequence":"first","affiliation":[{"name":"1Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom"},{"name":"2Department of Haematology, University of Cambridge, Cambridge, United 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of Translational Epidemiology, Division of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7794-610X","authenticated-orcid":false,"given":"Margarete A.","family":"Fabre","sequence":"additional","affiliation":[{"name":"2Department of Haematology, University of Cambridge, Cambridge, United Kingdom"},{"name":"9Centre for Genomics Research, Discovery Sciences, BioPharmaceuticals Research and Development, AstraZeneca, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7793-6291","authenticated-orcid":false,"given":"Pedro M.","family":"Quiros","sequence":"additional","affiliation":[{"name":"1Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom"},{"name":"2Department of Haematology, University of Cambridge, Cambridge, United 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