15-90761015-C-T

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_000057.4(BLM):​c.1642C>T​(p.Gln548*) variant causes a stop gained change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000145 in 1,606,372 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★). Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: 𝑓 0.00017 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00014 ( 0 hom. )

Consequence

BLM
NM_000057.4 stop_gained

Scores

2
4
1

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:30

Conservation

PhyloP100: 1.49
Variant links:
Genes affected
BLM (HGNC:1058): (BLM RecQ like helicase) The Bloom syndrome is an autosomal recessive disorder characterized by growth deficiency, microcephaly and immunodeficiency among others. It is caused by homozygous or compound heterozygous mutation in the gene encoding DNA helicase RecQ protein on chromosome 15q26. This Bloom-associated helicase unwinds a variety of DNA substrates including Holliday junction, and is involved in several pathways contributing to the maintenance of genome stability. Identification of pathogenic Bloom variants is required for heterozygote testing in at-risk families. [provided by RefSeq, May 2020]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 ACMG points.

PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 15-90761015-C-T is Pathogenic according to our data. Variant chr15-90761015-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 127478.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr15-90761015-C-T is described in Lovd as [Likely_pathogenic]. Variant chr15-90761015-C-T is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
BLMNM_000057.4 linkc.1642C>T p.Gln548* stop_gained Exon 7 of 22 ENST00000355112.8 NP_000048.1 P54132

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
BLMENST00000355112.8 linkc.1642C>T p.Gln548* stop_gained Exon 7 of 22 1 NM_000057.4 ENSP00000347232.3 P54132

Frequencies

GnomAD3 genomes
AF:
0.000171
AC:
26
AN:
152118
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.0000943
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000368
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.000139
AC:
34
AN:
244842
Hom.:
0
AF XY:
0.000113
AC XY:
15
AN XY:
132306
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000301
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000287
Gnomad OTH exome
AF:
0.000170
GnomAD4 exome
AF:
0.000142
AC:
207
AN:
1454138
Hom.:
0
Cov.:
31
AF XY:
0.000155
AC XY:
112
AN XY:
722866
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.0000232
Gnomad4 ASJ exome
AF:
0.0000388
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.000178
Gnomad4 OTH exome
AF:
0.000117
GnomAD4 genome
AF:
0.000171
AC:
26
AN:
152234
Hom.:
0
Cov.:
32
AF XY:
0.000148
AC XY:
11
AN XY:
74438
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.0000943
Gnomad4 NFE
AF:
0.000368
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000250
Hom.:
0
Bravo
AF:
0.000113
TwinsUK
AF:
0.000539
AC:
2
ALSPAC
AF:
0.00
AC:
0
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000233
AC:
2
ExAC
AF:
0.000181
AC:
22

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:30
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Bloom syndrome Pathogenic:19
Feb 02, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change creates a premature translational stop signal (p.Gln548*) in the BLM gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in BLM are known to be pathogenic (PMID: 17407155). This variant is present in population databases (rs200389141, gnomAD 0.03%). This premature translational stop signal has been observed in individual(s) with Bloom syndrome, breast cancer, colorectal cancer, and/or prostate cancer (PMID: 17407155, 23225144, 23552953, 24096176, 25399228, 26358404). It is commonly reported in individuals of Slavic ancestry (PMID: 23225144, 24096176). ClinVar contains an entry for this variant (Variation ID: 127478). RNA analysis performed to evaluate the impact of this premature translational stop signal on mRNA splicing indicates it does not significantly alter splicing (internal data). For these reasons, this variant has been classified as Pathogenic. -

Jun 28, 2020
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.Gln548X variant in BLM has been reported in at least 5 individuals with Bloom syndrome (2 homozygotes and 3 compound heterozygotes) and segregated with disease in at least 2 affected relatives from 1 family (German 2007 PMID: 17407155, Vojtkova 2016 PMID: 26340805, Suspitsin 2017 PMID: 28611551). In the heterozygous state, this variant is associated with an increased risk for developing breast cancer, particularly in the Slavic population (Sokolenko 2012 PMID: 21815139, Prokofyeva 2013 PMID: 23225144), although another study does not support its role as a susceptibility factor in breast cancer (Asiminenko 2014 PMID: 25399228). Additionally, this variant has also been reported by other clinical laboratories in ClinVar (Variation ID 127478) and has also been identified in 0.03% (43/126942) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org). However, this frequency is low enough to be consistent with a recessive allele frequency. This nonsense variant leads to a premature termination codon at position 548, which is predicted to lead to a truncated or absent protein. Loss of function of the BLM gene is an established disease mechanism in autosomal recessive Bloom syndrome. In summary, this variant meets criteria to be classified as pathogenic for autosomal recessive Bloom syndrome. ACMG/AMP Criteria applied: PVS1, PM3_Strong, PP1. -

Oct 10, 2024
St. Jude Molecular Pathology, St. Jude Children's Research Hospital
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The BLM c.1642C>T (p.Gln548Ter) change is a nonsense variant that is predicted to cause premature protein truncation and loss of normal protein function. This change is predicted to cause protein truncation or absence of the protein due to nonsense-mediated decay. Loss of function variants in BLM are known to be pathogenic (PMID: 28232778). This variant has a maximum subpopulation frequency of 0.034% in gnomAD v2.1.1 (https://gnomad.broadinstitute.org/). This variant has been reported in the homozygous and compound heterozygous state in individuals with Bloom syndrome (PMID: 17407155, 23552953, 26340805, 28611551, 33219493). Studies on breast, ovarian, and prostate cancer patients (PMID: 21815139, 24096176, 25182961, 25399228) have identified this variant in the heterozygous state in both cases and controls. In summary, this variant meets criteria to be classified as pathogenic. -

-
Medical Genetics, Medical University Pleven
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: research

- -

Aug 15, 2018
Illumina Laboratory Services, Illumina
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The BLM c.1642C>T (p.Gln548Ter) variant is a stop-gained variant predicted to result in premature termination of the protein. Across a selection of the available literature, the p.Gln548Ter variant has been identified in a total of eight individuals with Bloom syndrome, including in four in a homozygous state and in four in a compound heterozygous state (German et al. 2007; Classen et al. 2013; Vojtková et al. 2016; Suspitsin et al. 2017). The compound heterozygotes all carry a second null variant in trans including one deletion, one splice variant and two stop-gained variants. The p.Gln548Ter variant was found to segregate with disease in a two generation family. The p.Gln548Ter variant was reported in a heterozygous state in 32 of 8809 controls and is noted to be a founder variant in the Slavic population (Antczak et al. 2013; Bogdanova et al. 2015). The variant is reported at a frequency of 0.00033 in the European (non-Finnish) population of the Genome Aggregation Database. Based on the collective evidence and the potential impact of stop-gained variants, the p.Gln548Ter variant is classified as pathogenic for Bloom syndrome. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -

Dec 03, 2018
Broad Center for Mendelian Genomics, Broad Institute of MIT and Harvard
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

The homozygous p.Gln548Ter variant in BLM was identified by our study in one individual with Bloom syndrome. This variant has been identified in 0.03294% (41/124452) of European (non-Finnish) chromosomes by the Genome Aggregation Databse (gnomAD, http://gnomad.broadinsitute.org; dbSNP rs200389141). Although this variant has been seen in the general population, its frequency is low enough to be consistent with a recessive carrier frequency. This variant has been reported in the literature in the compound heterozygous state, with at least one variant reported pathogenic or likely pathogenic in ClinVar (Variation ID: 127491), in at least three individuals with Bloom syndrome (PMID: 17407155, 23552953). This nonsense variant leads to a premature termination codon at position 548, which is predicted to lead to a truncated or absent protein. Loss of function of the BLM gene is an established disease mechanism for autosomal recessive Bloom syndrome, and this is a loss of function variant. This variant has been reported pathogenic in ClinVar (Variation ID: 127478). In summary, the p.Gln548Ter variant is pathogenic. ACMG/AMP Criteria applied: PM2, PM3, PVS1 (Richards 2015). -

Dec 20, 2019
Myriad Genetics, Inc.
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

NM_000057.3(BLM):c.1642C>T(Q548*) is classified as pathogenic in the context of Bloom syndrome. Sources cited for classification include the following: PMID 17407155 and 28611551. Classification of NM_000057.3(BLM):c.1642C>T(Q548*) is based on the following criteria: The variant causes a premature termination codon that is expected to be targeted by nonsense-mediated mRNA decay and is reported in individuals with the relevant phenotype. Please note: this variant was assessed in the context of healthy population screening. -

May 09, 2024
Fulgent Genetics, Fulgent Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Aug 21, 2023
Diagnostics Centre, Carl Von Ossietzky University Oldenburg
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

The variant BLM:c.1642C>T p.(Gln548*), which is located in the coding exon 7 of the BLM gene, results from a cytosine to thymine substitution at nucleotide position 1642. The glutamine at protein position 548 is replaced by a stop codon at the translational level. The variant affects and exon (7/22) that is present in biologically relevant transcripts and is predicted to cause protein truncation/absent due to non-sense mediated decay in a gene where loss of function is a known mechanism of disease. The variant is classified as very rare in the overall population (allele frequency= 0.00017 in gnomAD v4.1.0). The variant has already been described in homozygous as well as compound heterozygous state in patients affected with BLM-associated disorders (PMID: 17407155, 23552953, 26340805, 28611551, 33219493). In summary, the variant is classified as Pathogenic. -

Jun 24, 2022
Victorian Clinical Genetics Services, Murdoch Childrens Research Institute
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0102 - Loss of function is a known mechanism of disease in this gene and is associated with Bloom syndrome (MIM#210900). (I) 0106 - This gene is associated with autosomal recessive disease. (I) 0201 - Variant is predicted to cause nonsense-mediated decay (NMD) and loss of protein (premature termination codon is located at least 54 nucleotides upstream of the final exon-exon junction). (SP) 0251 - This variant is heterozygous. (I) 0304 - Variant is present in gnomAD (v2) <0.01 for a recessive condition (46 heterozygotes, 0 homozygotes). (SP) 0701 - Other NMD predicted variants comparable to the one identified in this case have very strong previous evidence for pathogenicity (DECIPHER). (SP) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant has been observed in many individuals with Bloom syndrome in a homozygous or compound heterozygous state (ClinVar, PMIDs: 28611551, 32655338). (SP) 1205 - This variant has been shown to be maternally inherited (by trio analysis). (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -

Apr 02, 2020
Department of Molecular Diagnostics, Institute of Oncology Ljubljana
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Feb 01, 2024
Laboratory of Medical Genetics, National & Kapodistrian University of Athens
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: curation

- -

Jul 24, 2014
Pathway Genomics
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Jul 02, 2018
Mendelics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Mar 25, 2024
Baylor Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Nov 18, 2024
Institute of Human Genetics, University of Leipzig Medical Center
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Criteria applied: PVS1,PM3_VSTR -

Jun 03, 2016
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: The BLM c.1642C>T (p.Gln548X) variant results in a premature termination codon, predicted to cause a truncated or absent BLM protein due to nonsense mediated decay, which are commonly known mechanisms for disease. Truncations downstream of this position have been classified as pathogenic by our laboratory (e.g. c.2207_2212delinsTAGATTC). This variant was also found in 27/124630 control chromosomes at a frequency of 0.0002166, which does not exceed the estimated maximal expected allele frequency of a pathogenic BLM variant (0.0035355). This variant has been reported in three patients with Bloom syndrome, two were known to be compound heterozygotes with another deleterious variant. The variant is also known to confer risk for breast and other types of cancer. Multiple clinical diagnostic laboratories/reputable databases have classified this variant as pathogenic. Taken together, this variant is classified as pathogenic. -

Jan 07, 2019
Revvity Omics, Revvity
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Mar 16, 2017
Natera, Inc.
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

not provided Pathogenic:7
Oct 28, 2022
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This nonsense variant causes the premature termination of BLM protein synthesis. The frequency of this variant in the general population, 0.000339 (43/126942 chromosomes, http://gnomad.broadinstitute.org), is consistent with pathogenicity. In the published literature, the variant has been reported in individuals with breast cancer (PMID: 26822949 (2016), 25399228 (2014)), ovarian cancer (PMID: 25182961 (2015)), prostate cancer (PMID: 32923906 (2020), 24096176 (2013)), and colorectal cancer (PMID: 26358404 (2015)). The variant has been detected in individuals with Bloom Syndrome where individuals were compound heterozygous for the variant and a BLM pathogenic or likely pathogenic variant (PMID: 28611551 (2017), 26340805 (2016), 17407155 (2005). In addition, this variant has been reported as a Slavic founder mutation in individuals with breast cancer (PMID: 23225144 (2013), 21815139 (2012)). Based on the available information, this variant is classified as pathogenic. -

Jul 08, 2022
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Nonsense variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; This variant is associated with the following publications: (PMID: 30426508, 29506128, 26689913, 29625052, 26822949, 27153395, 29478780, 25399228, 24096176, 27798748, 23225144, 25410042, 21815139, 25525159, 17407155, 20301572, 26778106, 27597923, 26960971, 28611551, 31159747, 31614901, 31589614, 31937788, 33832920, 33777104, 33219493, 23552953, 32655338) -

-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Nov 25, 2015
Eurofins Ntd Llc (ga)
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Feb 01, 2025
CeGaT Center for Human Genetics Tuebingen
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

BLM: PVS1, PM3:Strong, PM2 -

-
Genome Diagnostics Laboratory, Amsterdam University Medical Center
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Hereditary cancer-predisposing syndrome Pathogenic:3
Aug 30, 2024
Ambry Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.Q548* pathogenic mutation (also known as c.1642C>T), located in coding exon 6 of the BLM gene, results from a C to T substitution at nucleotide position 1642. This changes the amino acid from a glutamine to a stop codon within coding exon 6. This mutation has been identified in the homozygous and compound heterozygous state with another pathogenic BLM mutation in multiple individuals with Bloom syndrome (German J et al. Hum. Mutat. 2007 Aug;28:743-53; Classen CF et al. Hum. Genet. 2013 Jul;132:825-41; Suspitsin EN et al. Mol Syndromol 2017 Mar;8(2):103-106). It has also been identified in the heterozygous state in individuals with breast cancer, prostate cancer, and colorectal cancer and is considered a possible Slavic founder mutation (Sokolenko AP et al. Int. J. Cancer. 2012 Jun;130:2867-73; Prokofyeva D et al. Breast Cancer Res. Treat. 2013 Jan;137:533-9; Lhota F et al. Clin. Genet. 2016 Oct;90:324-33; Maxwell KN et al. Am. J. Hum. Genet. 2016 May;98:801-17; deVoer RM et al. Sci Rep 2015 Sep;5:14060; Antczak A et al. Gene 2013 Dec;532(2):173-6). One case-control study in Poland identified this mutation in 82/14804 unselected breast cancer cases and 26/4698 cancer-free women (Kluzniak W et al. Cancers (Basel) 2019 Oct;11(10)). In addition to the clinical data presented in the literature, this alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation. -

Feb 13, 2021
Sema4, Sema4
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: curation

- -

Jan 01, 2020
GeneKor MSA
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This is a nonsense variant that creates a premature stop signal at codon 548 of the BLM protein. It is expected to result in an absent or disrupted protein product. This variant is a common founder mutation among Slavik populations, reported in up to 1% of breast cancer cases in Russia (PMID: 21815139). A meta-analysis study of this mutation has estimated the risk of breast cancer in carriers of this variant to be two to five times higher (PMID: 23225144). -

BLM-related disorder Pathogenic:1
Aug 01, 2024
PreventionGenetics, part of Exact Sciences
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

The BLM c.1642C>T variant is predicted to result in premature protein termination (p.Gln548*). This variant has been reported in multiple individuals with Bloom syndrome (Table 1, German et al. 2007. PubMed ID: 17407155; Suspitsin et al. 2017. PubMed ID: 28611551). It has been reported as a common founder variant in Slavic populations (Sokolenko et al. 2012. PubMed ID: 21815139; Prokofyeva et al. 2013. PubMed ID: 23225144). This variant is reported in 0.034% of alleles in individuals of European (non-Finnish) descent in gnomAD and is interpreted as pathogenic in ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/variation/127478/). Nonsense variants in BLM are expected to be pathogenic. This variant is interpreted as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.37
D
BayesDel_noAF
Pathogenic
0.58
CADD
Pathogenic
34
DANN
Uncertain
1.0
Eigen
Uncertain
0.46
Eigen_PC
Uncertain
0.23
FATHMM_MKL
Uncertain
0.88
D
Vest4
0.91
GERP RS
4.9

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.13
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs200389141; hg19: chr15-91304245; COSMIC: COSV61927526; COSMIC: COSV61927526; API