Summary
A national strategy for optimising genetic services in haemophilia A has been initiated
in the UK. Solid phase fluorescent chemical cleavage of mismatch is used to screen
the entire coding region of factor VIII in six segments: four amplified from the trace
of mRNA in blood lymphocytes and two from genomic DNA for the 3.4 kb exon 14 and flanking
intron sequences. These segments are analysed in two threefold multiplexes so that
the genes of 18 patients can be screened in a single ABI 377 gel. The promoter and
polyadenylation signal region are amplified and sequenced directly. We have analysed
142 unrelated patients and identified 141 factor VIII mutations and one Normandy type
von Willebrand homozygote. The former mutations include 89 missense, 10 nonsense,
5 frameshift, one 24 bp deletion and one splice signal defect. These comprise 71 different
changes, of which 39 have not been previously observed.