Performance Evaluation of Whole-Genome Amplification Platforms for Clinical Next-Generation Sequencing with Minimal...

Next-generation sequencing (NGS) is increasingly applied in clinical diagnostics; however, standard workflows are frequently challenged by insufficient DNA yields in diverse clinical scenarios. Although whole-genome amplification (WGA) is used to overcome this limitation, comparative performance data on WGA kits based on different amplification mechanisms under low-input conditions remain scarce.

We systematically evaluated four commercial WGA platforms: REPLI-g (Qiagen), which employs multiple displacement amplification; PicoPLEX (Takara Bio) and SurePlex (Illumina), which utilize modified multiple annealing and looping-based amplification cycles (MALBAC); and ResolveDNA (BioSkryb Genomics), which uses primary template-directed amplification (PTA), using 100-pg and 1-ng DNA input. Performance was assessed by examining allelic dropout (ADO), chimerism, copy number variation (CNV), and the total DNA yield.

ResolveDNA showed the lowest ADO rates across input levels, whereas PicoPLEX offered the most accurate quantification for chimerism and CNV. REPLI-g had the highest DNA yield but exhibited marked amplification bias and ADO under ultra-low-input conditions. SurePlex demonstrated intermediate performance across all metrics. PicoPLEX and SurePlex showed consistent CNV detection and chimerism accuracy, whereas PTA-based ResolveDNA better preserved allelic balance.

Each platform demonstrated specific strengths and limitations depending on analytical endpoints. Modified MALBAC-based platforms can perform optimally when quantitative accuracy is critical, such as in chimerism or CNV analysis, whereas PTA-based WGA can be preferred when allelic fidelity is essential. Our findings can help guide platform selection tailored to specific clinical applications using low-input NGS, including preimplantation testing or cell-free DNA analysis.