Dyskeratosis congenita (DKC) is a rare human genetic disorderaffecting telomere replication. Mutations in thegenes encoding the protein or RNA subunits of telomeraseresult in very short telomeres. DKC symptoms include bonemarrow failure (reduced production of blood cells) and anemia.If symptoms are severe, a bone marrow transplant may be theonly form of effective treatment. In one case, clinicians recommendedthat a 27-year-old woman with a dominant form of DKCundergo a bone marrow transplant to treat the disorder. Her foursiblings were tested, and her 13-year-old brother was identifiedas the best immunologically matched donor. However, beforebeing tested, he was emphatic that he did not want to knowif he had DKC. During testing, it was discovered that he hadunusually short telomeres and would most likely develop symptomsof DKC. Although the brother is an immunologically matched donor for his sister, it would be unethical for the clinicians to transplant bone marrow from the brother to the sister. Why?
Dyskeratosis congenita (DKC) is a rare human genetic disorder
affecting telomere replication. Mutations in the
genes encoding the protein or RNA subunits of telomerase
result in very short telomeres. DKC symptoms include bone
marrow failure (reduced production of blood cells) and anemia.
If symptoms are severe, a bone marrow transplant may be the
only form of effective treatment. In one case, clinicians recommended
that a 27-year-old woman with a dominant form of DKC
undergo a bone marrow transplant to treat the disorder. Her four
siblings were tested, and her 13-year-old brother was identified
as the best immunologically matched donor. However, before
being tested, he was emphatic that he did not want to know
if he had DKC. During testing, it was discovered that he had
unusually short telomeres and would most likely develop symptoms
of DKC. Although the brother is an immunologically matched donor for
his sister, it would be unethical for the clinicians to transplant
bone marrow from the brother to the sister. Why?
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