Supplemental Table 1.

Article Title: Juvenile Myelomonocytic Leukemia Due to a Germline CBL Y371C Mutation: 35-Year Follow-up of a Large Family

Journal Name: Human Genetics

Author Names and Affiliations:

Anand Pathak1, Alexander Pemov1, Mary Lou McMaster2, Ramita Dewan1, Sarangan Ravichandran3, Evgenia Pak4, Amalia Dutra4, Hyo Jung Lee5, Aurelie Vogt5, Xijun Zhang5, Meredith Yeager5, Stacie Anderson6, Martha Kirby6, NCI DCEG Cancer Genomics Research Laboratory, NCI DCEG Cancer Sequencing Working Group, Neil Caporaso2, Mark H. Greene1, Lynn Goldin2, Douglas R. Stewart1

1Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;

2Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;

3Frederick National Laboratory for Cancer Research; Simulation, Analysis, and Mathematical Modeling Group Advanced Biomedical Computing Center, Frederick, MD, USA;

4Cytogenetic and Microscopy Core, Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA;

5Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA;

6Flow Cytometry Core, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.

NCI DCEG Cancer Sequencing Working Group: Bari Ballew, Stephen J. Chanock, Alisa M. Goldstein, Allan Hildesheim, Nan Hu, Maria Teresa Landi, Jennifer Loud, Phuong L. Mai, Lisa Mirabello, Lindsay Morton, Dilys Parry, Melissa Rotunno, Sharon A. Savage, Philip R. Taylor, Geoffrey S. Tobias, Margaret A. Tucker, Jeannette Wong, Xiaohong R. Yang, Guoqin Yu

NCI DCEG Cancer Genomics Research Laboratory: Sara Bass, Joseph Boland, Laurie Burdette, Salma Chowdhury, Michael Cullen, Casey Dagnall, Herbert Higson, Amy A. Hutchinson, Kristine Jones, Sally Larson, Kerrie Lashley, Hyo Jung Lee, Wen Luo, Michael Malasky, Michelle Manning, Jason Mitchell, David Roberson, Aurelie Vogt, Mingyi Wang

Key words: JMML, familial, CBL, germline mutation, whole-exome sequencing

Correspondence to: DRS (9609 Medical Center Drive Rm 6E450, Bethesda, MD, 20892; Tel: 240-276-7238; Fax: 240-276-7836; )

Supplemental Table 1. World Health Organization Clinical Criteria for Juvenile Myelomonocytic Leukemia.*

Laboratory Criteria / IV.2 / III.12 / III.1
Persistent peripheral blood monocytosis >1x109/L / 1600/µL (9/2010); 1500/µL (3/2011); 1300/µL (11/2013) / 1904/µL (6/1993); 3800/µL (7/2014); 1,500/µL (9/2014) / 924/µL (2/1949); 820 (12/2012)
Blasts are <20% in peripheral blood and bone marrow / 2% peripheral blood, 8% bone marrow / < 2% blasts bone marrow / 2 % blasts peripheral blood
No Philadelphia chromosome / No Philadelphia chromosome / No Philadelphia chromosome / No Philadelphia chromosome
Further Criteria
Hemoglobin F increased for age / 6.70% (>1.0% abnormal) / No documentation of elevation / No documentation of elevation
Immature granulocytes in the peripheral blood / Yes / Yes / Yes
WBC count >10x109/L. / Yes / Yes / Yes
Clonal chromosomal abnormality (may be monosomy 7) / No / No / No
GM-CSF hypersensitivity of myeloid progenitors in vitro / N/A / N/A / N/A

* To meet diagnostic criteria, a patient must meet all three laboratory criteria and fulfill at least two further criteria.

Table 2. In Silico Predictions of CBL Y371C Pathogenicity

PREDICTION PROGRAM / SCORE / INTERPRETATION
SIFT / 0 / Deleterious
POLYPHEN 2 HumDiv / 0.999 / Probably Damaging
POLYPHEN 2 HumVar / 1.000 / Probably Damaging
MUTATION TASTER / 0.999999 / Disease Causing
MUTATION ASSESSOR / 2.35 / Medium
FATHMM--MISSENSE / -4.09 / Damaging
FATHMM--CANCER / -5.39 / Cancer
CADD SCALED C-SCORE / 16.7 / Between top 10% (10) and top 1% (20)