A Krüppel-Like Factor 1 Gene Mutation Ameliorates the Severity of β -Thalassemia: A Case Report.

Patients with the beta(0)/beta(0) type of beta-thalassemia (beta-thal) usually present as beta-thal major (beta-TM), and are transfusion-dependent. However, the clinical and hematological features of beta-thal can be modulated by different modifiers, resulting in a wide range of clinical severity even in patients with the same genotypes. We report a Chinese family with twin brothers, both of whom had the same genotype of beta(0)/beta(0). One twin was diagnosed as beta-TM at 4 months of age and had regularly been transfused; conversely the other twin with a KLF1 (Kruppel-like factor 1) gene mutation, behaved as beta-thal intermedia (beta-TI), and had never been transfused. Our findings indicate that KLF1 mutations have a role in modulating the phenotypic severity of beta-thal. The exact investigation of KLF1 modifiers is necessary in areas where globin gene disorders are most prevalent. This will be helpful in genetic counseling and optimizing the guidelines for prenatal diagnosis (PND) programs.