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Center for Computational Systems Medicine level1
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Fusion Gene Summary

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Fusion Gene Sample Information

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Fusion ORF Analysis

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Fusion Amino Acid Sequences

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Fusion Protein Functional Features

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Fusion Protein-Protein Interaction

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Related drugs with this fusion protein

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Related disease with this fusion protein

Fusion Protein:KIT-PDGFRA

Fusion Protein Summary

check button Fusion gene summary
Fusion partner gene informationFusion gene name: KIT-PDGFRA
FusionPDB ID: 42806
FusionGDB2.0 ID: 42806
HgeneTgene
Gene symbol

KIT

PDGFRA

Gene ID

3815

5156

Gene nameKIT proto-oncogene, receptor tyrosine kinaseplatelet derived growth factor receptor alpha
SynonymsC-Kit|CD117|MASTC|PBT|SCFRCD140A|PDGFR-2|PDGFR2
Cytomap

4q12

4q12

Type of geneprotein-codingprotein-coding
Descriptionmast/stem cell growth factor receptor Kitc-Kit protooncogenep145 c-kitpiebald trait proteinproto-oncogene c-Kitproto-oncogene tyrosine-protein kinase Kitsoluble KIT variant 1tyrosine-protein kinase Kitv-kit Hardy-Zuckerman 4 feline sarcoma viral oplatelet-derived growth factor receptor alphaCD140 antigen-like family member ACD140a antigenPDGF-R-alphaalpha-type platelet-derived growth factor receptorplatelet-derived growth factor receptor 2platelet-derived growth factor receptor, alpha polype
Modification date2020031320200329
UniProtAcc

P21583

P16234

Ensembl transtripts involved in fusion geneENST idsENST00000288135, ENST00000257290, 
ENST00000508170, 
Fusion gene scores for assessment (based on all fusion genes of FusionGDB 2.0)* DoF score9 X 8 X 5=36018 X 27 X 8=3888
# samples 917
** MAII scorelog2(9/360*10)=-2
possibly effective Gene in Pan-Cancer Fusion Genes (peGinPCFGs).
DoF>8 and MAII<0
log2(17/3888*10)=-4.51542156746808
possibly effective Gene in Pan-Cancer Fusion Genes (peGinPCFGs).
DoF>8 and MAII<0
Context (manual curation of fusion genes in FusionPDB)

PubMed: KIT [Title/Abstract] AND PDGFRA [Title/Abstract] AND fusion [Title/Abstract]

Most frequent breakpoint (based on all fusion genes of FusionGDB 2.0)KIT(55524248)-PDGFRA(55124924), # samples:1
KIT(55524248)-PDGFRA(55127262), # samples:1
Anticipated loss of major functional domain due to fusion event.KIT-PDGFRA seems lost the major protein functional domain in Hgene partner, which is a CGC by not retaining the major functional domain in the partially deleted in-frame ORF.
KIT-PDGFRA seems lost the major protein functional domain in Hgene partner, which is a CGC by not retaining the major functional domain in the partially deleted in-frame ORF.
KIT-PDGFRA seems lost the major protein functional domain in Hgene partner, which is a essential gene by not retaining the major functional domain in the partially deleted in-frame ORF.
KIT-PDGFRA seems lost the major protein functional domain in Hgene partner, which is a essential gene by not retaining the major functional domain in the partially deleted in-frame ORF.
* DoF score (Degree of Frequency) = # partners X # break points X # cancer types
** MAII score (Major Active Isofusion Index) = log2(# samples/DoF score*10)

check button Gene ontology of each fusion partner gene with evidence of Inferred from Direct Assay (IDA) from Entrez
PartnerGeneGO IDGO termPubMed ID
HgeneKIT

GO:0000187

activation of MAPK activity

21640708

HgeneKIT

GO:0002551

mast cell chemotaxis

20100931

HgeneKIT

GO:0018108

peptidyl-tyrosine phosphorylation

21640708

HgeneKIT

GO:0019221

cytokine-mediated signaling pathway

21640708

HgeneKIT

GO:0031532

actin cytoskeleton reorganization

1721869

HgeneKIT

GO:0032762

mast cell cytokine production

20100931

HgeneKIT

GO:0038093

Fc receptor signaling pathway

20100931

HgeneKIT

GO:0038109

Kit signaling pathway

17662946

HgeneKIT

GO:0046777

protein autophosphorylation

21640708

HgeneKIT

GO:0060326

cell chemotaxis

1721869

HgeneKIT

GO:1905065

positive regulation of vascular smooth muscle cell differentiation

19088079

TgenePDGFRA

GO:0008284

positive regulation of cell proliferation

10806482

TgenePDGFRA

GO:0010544

negative regulation of platelet activation

8188664

TgenePDGFRA

GO:0018108

peptidyl-tyrosine phosphorylation

1646396|2536956|8188664

TgenePDGFRA

GO:0030335

positive regulation of cell migration

17470632

TgenePDGFRA

GO:0034614

cellular response to reactive oxygen species

24190966

TgenePDGFRA

GO:0038091

positive regulation of cell proliferation by VEGF-activated platelet derived growth factor receptor signaling pathway

17470632

TgenePDGFRA

GO:0046777

protein autophosphorylation

1646396|2536956|8188664

TgenePDGFRA

GO:0048008

platelet-derived growth factor receptor signaling pathway

2536956|10806482

TgenePDGFRA

GO:0048146

positive regulation of fibroblast proliferation

10806482


check buttonFusion gene breakpoints across KIT (5'-gene)
* Click on the image to open the UCSC genome browser with custom track showing this image in a new window.
all structure

check buttonFusion gene breakpoints across PDGFRA (3'-gene)
* Click on the image to open the UCSC genome browser with custom track showing this image in a new window.
all structure


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Fusion Gene Sample Information

check buttonFusion gene information from FusionGDB2.0.
check button Fusion gene information from two resources (ChiTars 5.0 and ChimerDB 4.0)
* All genome coordinats were lifted-over on hg19.
* Click on the break point to see the gene structure around the break point region using the UCSC Genome Browser.
SourceDiseaseSampleHgeneHchrHbpHstrandTgeneTchrTbpTstrand
ChimerDB4BRCATCGA-BH-A1F0-01AKITchr4

55524248

+PDGFRAchr4

55124924

+
ChimerDB4BRCATCGA-BH-A1F0-01AKITchr4

55524248

+PDGFRAchr4

55127262

+


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Fusion ORF Analysis


check buttonFusion information from ORFfinder translation from full-length transcript sequence from FusionPDB.
HenstTenstHgeneHchrHbpHstrandTgeneTchrTbpTstrandSeq length
(transcript)
BP loci
(transcript)
Predicted start
(transcript)
Predicted stop
(transcript)
Seq length
(amino acids)
ENST00000288135KITchr455524248+ENST00000257290PDGFRAchr455127262+63601642533841119
ENST00000288135KITchr455524248+ENST00000508170PDGFRAchr455127262+216916425771248

check buttonDeepORF prediction of the coding potential based on the fusion transcript sequence of in-frame fusion genes. DeepORF is a coding potential classifier based on convolutional neural network by comparing the real Ribo-seq data. If the no-coding score < 0.5 and coding score > 0.5, then the in-frame fusion transcript is predicted as being likely translated.
HenstTenstHgeneHchrHbpHstrandTgeneTchrTbpTstrandNo-coding scoreCoding score
ENST00000288135ENST00000257290KITchr455524248+PDGFRAchr455127262+0.0001675110.9998325
ENST00000288135ENST00000508170KITchr455524248+PDGFRAchr455127262+0.0004975280.9995024

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Fusion Amino Acid Sequences


check button For individual full-length fusion transcript sequence from FusionPDB, we ran ORFfinder and chose the longest ORF among the all predicted ones.
>FusionGDB ID_FusionGDB isoform ID_FGname_Hgene_Hchr_Hbp_Henst_Tgene_Tchr_Tbp_Tenst_length(fusion AA) seq_BP

>42806_42806_1_KIT-PDGFRA_KIT_chr4_55524248_ENST00000288135_PDGFRA_chr4_55127262_ENST00000257290_length(amino acids)=1119AA_BP=46
MPRSLHLGESWNVDQSSDPIAATAMRGARGAWDFLCVLLLLLRVQTGLSLILCQLSLPSILPNENEKVVQLNSSFSLRCFGESEVSWQYP
MSEEESSDVEIRNEENNSGLFVTVLEVSSASAAHTGLYTCYYNHTQTEENELEGRHIYIYVPDPDVAFVPLGMTDYLVIVEDDDSAIIPC
RTTDPETPVTLHNSEGVVPASYDSRQGFNGTFTVGPYICEATVKGKKFQTIPFNVYALKATSELDLEMEALKTVYKSGETIVVTCAVFNN
EVVDLQWTYPGEVKGKGITMLEEIKVPSIKLVYTLTVPEATVKDSGDYECAARQATREVKEMKKVTISVHEKGFIEIKPTFSQLEAVNLH
EVKHFVVEVRAYPPPRISWLKNNLTLIENLTEITTDVEKIQEIRYRSKLKLIRAKEEDSGHYTIVAQNEDAVKSYTFELLTQVPSSILDL
VDDHHGSTGGQTVRCTAEGTPLPDIEWMICKDIKKCNNETSWTILANNVSNIITEIHSRDRSTVEGRVTFAKVEETIAVRCLAKNLLGAE
NRELKLVAPTLRSELTVAAAVLVLLVIVIISLIVLVVIWKQKPRYEIRWRVIESISPDGHEYIYVDPMQLPYDSRWEFPRDGLVLGRVLG
SGAFGKVVEGTAYGLSRSQPVMKVAVKMLKPTARSSEKQALMSELKIMTHLGPHLNIVNLLGACTKSGPIYIITEYCFYGDLVNYLHKNR
DSFLSHHPEKPKKELDIFGLNPADESTRSYVILSFENNGDYMDMKQADTTQYVPMLERKEVSKYSDIQRSLYDRPASYKKKSMLDSEVKN
LLSDDNSEGLTLLDLLSFTYQVARGMEFLASKNCVHRDLAARNVLLAQGKIVKICDFGLARDIMHDSNYVSKGSTFLPVKWMAPESIFDN
LYTTLSDVWSYGILLWEIFSLGGTPYPGMMVDSTFYNKIKSGYRMAKPDHATSEVYEIMVKCWNSEPEKRPSFYHLSEIVENLLPGQYKK
SYEKIHLDFLKSDHPAVARMRVDSDNAYIGVTYKNEEDKLKDWEGGLDEQRLSADSGYIIPLPDIDPVPEEEDLGKRNRHSSQTSEESAI

--------------------------------------------------------------

>42806_42806_2_KIT-PDGFRA_KIT_chr4_55524248_ENST00000288135_PDGFRA_chr4_55127262_ENST00000508170_length(amino acids)=248AA_BP=46
MPRSLHLGESWNVDQSSDPIAATAMRGARGAWDFLCVLLLLLRVQTGLSLILCQLSLPSILPNENEKVVQLNSSFSLRCFGESEVSWQYP
MSEEESSDVEIRNEENNSGLFVTVLEVSSASAAHTGLYTCYYNHTQTEENELEGRHIYIYVPDPDVAFVPLGMTDYLVIVEDDDSAIIPC

--------------------------------------------------------------

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Fusion Protein Functional Features


check button Four levels of functional features of fusion genes
Go to FGviewer search page for the most frequent breakpoint (https://ccsmweb.uth.edu/FGviewer/chr4:55524248/chr4:55124924)
- FGviewer provides the online visualization of the retention search of the protein functional features across DNA, RNA, protein, and pathological levels.
- How to search
1. Put your fusion gene symbol.
2. Press the tab key until there will be shown the breakpoint information filled.
4. Go down and press 'Search' tab twice.
4. Go down to have the hyperlink of the search result.
5. Click the hyperlink.
6. See the FGviewer result for your fusion gene.
FGviewer

check buttonMain function of each fusion partner protein. (from UniProt)
HgeneTgene
KIT

P21583

PDGFRA

P16234

FUNCTION: Ligand for the receptor-type protein-tyrosine kinase KIT. Plays an essential role in the regulation of cell survival and proliferation, hematopoiesis, stem cell maintenance, gametogenesis, mast cell development, migration and function, and in melanogenesis. KITLG/SCF binding can activate several signaling pathways. Promotes phosphorylation of PIK3R1, the regulatory subunit of phosphatidylinositol 3-kinase, and subsequent activation of the kinase AKT1. KITLG/SCF and KIT also transmit signals via GRB2 and activation of RAS, RAF1 and the MAP kinases MAPK1/ERK2 and/or MAPK3/ERK1. KITLG/SCF and KIT promote activation of STAT family members STAT1, STAT3 and STAT5. KITLG/SCF and KIT promote activation of PLCG1, leading to the production of the cellular signaling molecules diacylglycerol and inositol 1,4,5-trisphosphate. KITLG/SCF acts synergistically with other cytokines, probably interleukins.FUNCTION: Tyrosine-protein kinase that acts as a cell-surface receptor for PDGFA, PDGFB and PDGFC and plays an essential role in the regulation of embryonic development, cell proliferation, survival and chemotaxis. Depending on the context, promotes or inhibits cell proliferation and cell migration. Plays an important role in the differentiation of bone marrow-derived mesenchymal stem cells. Required for normal skeleton development and cephalic closure during embryonic development. Required for normal development of the mucosa lining the gastrointestinal tract, and for recruitment of mesenchymal cells and normal development of intestinal villi. Plays a role in cell migration and chemotaxis in wound healing. Plays a role in platelet activation, secretion of agonists from platelet granules, and in thrombin-induced platelet aggregation. Binding of its cognate ligands - homodimeric PDGFA, homodimeric PDGFB, heterodimers formed by PDGFA and PDGFB or homodimeric PDGFC -leads to the activation of several signaling cascades; the response depends on the nature of the bound ligand and is modulated by the formation of heterodimers between PDGFRA and PDGFRB. Phosphorylates PIK3R1, PLCG1, and PTPN11. Activation of PLCG1 leads to the production of the cellular signaling molecules diacylglycerol and inositol 1,4,5-trisphosphate, mobilization of cytosolic Ca(2+) and the activation of protein kinase C. Phosphorylates PIK3R1, the regulatory subunit of phosphatidylinositol 3-kinase, and thereby mediates activation of the AKT1 signaling pathway. Mediates activation of HRAS and of the MAP kinases MAPK1/ERK2 and/or MAPK3/ERK1. Promotes activation of STAT family members STAT1, STAT3 and STAT5A and/or STAT5B. Receptor signaling is down-regulated by protein phosphatases that dephosphorylate the receptor and its down-stream effectors, and by rapid internalization of the activated receptor. {ECO:0000269|PubMed:10734113, ECO:0000269|PubMed:10947961, ECO:0000269|PubMed:11297552, ECO:0000269|PubMed:12522257, ECO:0000269|PubMed:1646396, ECO:0000269|PubMed:17087943, ECO:0000269|PubMed:1709159, ECO:0000269|PubMed:17141222, ECO:0000269|PubMed:20972453, ECO:0000269|PubMed:21224473, ECO:0000269|PubMed:21596750, ECO:0000269|PubMed:2554309, ECO:0000269|PubMed:8188664, ECO:0000269|PubMed:8760137, ECO:0000269|PubMed:8943348}.

check buttonRetention analysis result of each fusion partner protein across 39 protein features of UniProt such as six molecule processing features, 13 region features, four site features, six amino acid modification features, two natural variation features, five experimental info features, and 3 secondary structure features. Here, because of limited space for viewing, we only show the protein feature retention information belong to the 13 regional features. All retention annotation result can be downloaded at

download page

* Minus value of BPloci means that the break pointn is located before the CDS.
- Retained protein feature among the 13 regional features.
PartnerGeneHbpTbpENSTStrandBPexonTotalExonProtein feature loci*BPlociTotalLenProtein featureProtein feature note
TgenePDGFRAchr4:55524248chr4:55127262ENST000002572901231041_108716.3333333333333321090.0Compositional biasNote=Ser-rich
TgenePDGFRAchr4:55524248chr4:55127262ENST00000508170141041_108716.333333333333332219.0Compositional biasNote=Ser-rich
TgenePDGFRAchr4:55524248chr4:55127262ENST00000257290123117_20116.3333333333333321090.0DomainNote=Ig-like C2-type 2
TgenePDGFRAchr4:55524248chr4:55127262ENST00000257290123202_30616.3333333333333321090.0DomainNote=Ig-like C2-type 3
TgenePDGFRAchr4:55524248chr4:55127262ENST0000025729012324_11316.3333333333333321090.0DomainNote=Ig-like C2-type 1
TgenePDGFRAchr4:55524248chr4:55127262ENST00000257290123319_41016.3333333333333321090.0DomainNote=Ig-like C2-type 4
TgenePDGFRAchr4:55524248chr4:55127262ENST00000257290123414_51716.3333333333333321090.0DomainNote=Ig-like C2-type 5
TgenePDGFRAchr4:55524248chr4:55127262ENST00000257290123593_95416.3333333333333321090.0DomainProtein kinase
TgenePDGFRAchr4:55524248chr4:55127262ENST0000050817014117_20116.333333333333332219.0DomainNote=Ig-like C2-type 2
TgenePDGFRAchr4:55524248chr4:55127262ENST0000050817014202_30616.333333333333332219.0DomainNote=Ig-like C2-type 3
TgenePDGFRAchr4:55524248chr4:55127262ENST000005081701424_11316.333333333333332219.0DomainNote=Ig-like C2-type 1
TgenePDGFRAchr4:55524248chr4:55127262ENST0000050817014319_41016.333333333333332219.0DomainNote=Ig-like C2-type 4
TgenePDGFRAchr4:55524248chr4:55127262ENST0000050817014414_51716.333333333333332219.0DomainNote=Ig-like C2-type 5
TgenePDGFRAchr4:55524248chr4:55127262ENST0000050817014593_95416.333333333333332219.0DomainProtein kinase
TgenePDGFRAchr4:55524248chr4:55127262ENST00000257290123599_60716.3333333333333321090.0Nucleotide bindingATP
TgenePDGFRAchr4:55524248chr4:55127262ENST0000050817014599_60716.333333333333332219.0Nucleotide bindingATP
TgenePDGFRAchr4:55524248chr4:55127262ENST0000025729012324_52816.3333333333333321090.0Topological domainExtracellular
TgenePDGFRAchr4:55524248chr4:55127262ENST00000257290123550_108916.3333333333333321090.0Topological domainCytoplasmic
TgenePDGFRAchr4:55524248chr4:55127262ENST000005081701424_52816.333333333333332219.0Topological domainExtracellular
TgenePDGFRAchr4:55524248chr4:55127262ENST0000050817014550_108916.333333333333332219.0Topological domainCytoplasmic
TgenePDGFRAchr4:55524248chr4:55127262ENST00000257290123529_54916.3333333333333321090.0TransmembraneHelical
TgenePDGFRAchr4:55524248chr4:55127262ENST0000050817014529_54916.333333333333332219.0TransmembraneHelical

- Not-retained protein feature among the 13 regional features.
PartnerGeneHbpTbpENSTStrandBPexonTotalExonProtein feature loci*BPlociTotalLenProtein featureProtein feature note
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121121_20522.333333333333332977.0DomainNote=Ig-like C2-type 2
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121212_30822.333333333333332977.0DomainNote=Ig-like C2-type 3
HgeneKITchr4:55524248chr4:55127262ENST00000288135+12127_11222.333333333333332977.0DomainNote=Ig-like C2-type 1
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121317_41022.333333333333332977.0DomainNote=Ig-like C2-type 4
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121413_50722.333333333333332977.0DomainNote=Ig-like C2-type 5
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121589_93722.333333333333332977.0DomainProtein kinase
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121596_60322.333333333333332977.0Nucleotide bindingNote=ATP
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121671_67722.333333333333332977.0Nucleotide bindingNote=ATP
HgeneKITchr4:55524248chr4:55127262ENST00000288135+12126_52422.333333333333332977.0Topological domainExtracellular
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121546_97622.333333333333332977.0Topological domainCytoplasmic
HgeneKITchr4:55524248chr4:55127262ENST00000288135+121525_54522.333333333333332977.0TransmembraneHelical


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Fusion Protein-Protein Interaction


check button Go to ChiPPI (Chimeric Protein-Protein interactions) to see the chimeric PPI interaction in

ChiPPI page.


check button Protein-protein interactors with each fusion partner protein in wild-type from validated records (BIOGRID-3.4.160)
GenePPI interactors


check button Protein-protein interactors based on sequence similarity (STRING)
GeneSTRING network
KIT
PDGFRA


check button - Retained interactions in fusion protein (protein functional feature from UniProt).
PartnerGeneHbpTbpENSTStrandBPexonTotalExonProtein feature loci*BPlociTotalLenStill interaction with


check button - Lost interactions due to fusion (protein functional feature from UniProt).
PartnerGeneHbpTbpENSTStrandBPexonTotalExonProtein feature loci*BPlociTotalLenInteraction lost with


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Related Drugs to KIT-PDGFRA


check button Drugs used for this fusion-positive patient.
(Manual curation of PubMed, 04-30-2022 + MyCancerGenome)
HgeneTgeneDrugSourcePMID

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Related Diseases to KIT-PDGFRA


check button Diseases that have this fusion gene.
(Manual curation of PubMed, 04-30-2022 + MyCancerGenome)
HgeneTgeneDiseaseSourcePMID

check button Diseases associated with fusion partners.
(DisGeNet 4.0)
PartnerGeneDisease IDDisease name# pubmedsSource
TgenePDGFRAC0238198Gastrointestinal Stromal Tumors10CGI;CLINGEN;CTD_human;GENOMICS_ENGLAND;ORPHANET;UNIPROT
TgenePDGFRAC3179349Gastrointestinal Stromal Sarcoma9CLINGEN;CTD_human;ORPHANET
TgenePDGFRAC0346421Chronic eosinophilic leukemia4ORPHANET
TgenePDGFRAC0206141Idiopathic Hypereosinophilic Syndrome3CTD_human;GENOMICS_ENGLAND
TgenePDGFRAC0006413Burkitt Lymphoma2ORPHANET
TgenePDGFRAC0206142Eosinophilic leukemia2CTD_human
TgenePDGFRAC0206143Loeffler's Endocarditis2CTD_human
TgenePDGFRAC1292769Precursor B-cell lymphoblastic leukemia2ORPHANET
TgenePDGFRAC1540912Hypereosinophilic syndrome2CGI;CTD_human
TgenePDGFRAC0008925Cleft Palate1CTD_human
TgenePDGFRAC0015923Fetal Alcohol Syndrome1PSYGENET
TgenePDGFRAC0018801Heart failure1CTD_human
TgenePDGFRAC0018802Congestive heart failure1CTD_human
TgenePDGFRAC0023212Left-Sided Heart Failure1CTD_human
TgenePDGFRAC0023893Liver Cirrhosis, Experimental1CTD_human
TgenePDGFRAC0024115Lung diseases1CTD_human
TgenePDGFRAC0025149Medulloblastoma1CTD_human
TgenePDGFRAC0035238Congenital abnormality of respiratory system1CTD_human
TgenePDGFRAC0038219Status Dysraphicus1CTD_human
TgenePDGFRAC0080178Spina Bifida1CTD_human
TgenePDGFRAC0205833Medullomyoblastoma1CTD_human
TgenePDGFRAC0206637Mesenchymal Chondrosarcoma1CTD_human
TgenePDGFRAC0235527Heart Failure, Right-Sided1CTD_human
TgenePDGFRAC0266508Rachischisis1CTD_human
TgenePDGFRAC0278510Childhood Medulloblastoma1CTD_human
TgenePDGFRAC0278876Adult Medulloblastoma1CTD_human
TgenePDGFRAC0376634Craniofacial Abnormalities1CTD_human
TgenePDGFRAC0751291Desmoplastic Medulloblastoma1CTD_human
TgenePDGFRAC1275668Melanotic medulloblastoma1CTD_human
TgenePDGFRAC1837218Cleft palate, isolated1CTD_human
TgenePDGFRAC1959583Myocardial Failure1CTD_human
TgenePDGFRAC1961112Heart Decompensation1CTD_human
TgenePDGFRAC2718076Fetal Mummification1CTD_human
TgenePDGFRAC2985290Fetal Alcohol Spectrum Disorders1PSYGENET
TgenePDGFRAC4545381Myeloid and/or lymphoid neoplasm associated with platelet derived growth factor receptor alpha rearrangement1ORPHANET