Non-spherocytic hemolytic anemia caused by erythrocyte pyruvate kinase defiiency: the analysis of genetic defects in pediatric patients, living in Russian Federation

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  • Authors: Cherniak E.A.1, Sokolova N.E.2, Semiglazova K.V.1, Lavrentyeva I.N.3, Donush E.K.4, Plaksina O.I.5, Borisova M.V.6, Danilyuk N.A.7, Mitrofanova E.S.8, Baturskaya I.P.9, Revina N.G.10, Burlutskaya T.I.11, Rakov M.A.12, Evstratov A.V.13, Tselousova O.M.14, Lebedev V.V.15, Chaplygina N.V.16, Koryakina I.V.17, Osmulskaya N.S.18, Afanasyeva E.I.19, Nikonova O.E.20, Sokolova L.I.21, Tsedenisheeva E.K.22, Yunusova I.M.23, Zauralov E.O.24, Osipova I.V.25, Aslanyan K.S.26, Sipacheva E.V.27, Boldyreva O.P.28, Kazaryan G.R.29, Basharova E.V.30, Mann S.G.31, Kurnikova M.A.31, Raikina E.V.31, Smetanina N.S.31
  • Affiliations:
    1. Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian Federation, Moscow
    2. Children's City Multidisciplinary Clinical Specialized Center of High Medical Technologies, Saint-Petersburg
    3. Morozov Children’s City Clinical Hospital, Department of Health in Moscow, Moscow
    4. Russian Children's Clinical Hospital of the N.I. Pirogov Russian National Research Medical University of Ministry of Healthcare of the Russian Federation, Moscow
    5. Regional Children's Clinical Hospital, Nizhny Novgorod
    6. Krasnoyarsk Regional Clinical Center for Maternity and Childhood Protection, Perinatal Center, Krasnoyarsk
    7. Regional Oncological Dispensary, Penza
    8. Children's Regional Clinical Hospital, Tula
    9. Amur Regional Children's Clinical Hospital, Blagoveshchensk
    10. Regional Children's Clinical Hospital named after P.G. Vyzhletsova, Arkhangelsk
    11. Children's Regional Clinical Hospital, Belgorod
    12. Regional Children's Hospital, Bryansk
    13. Regional Clinical Children's Hospital, Kaluga
    14. Kirov Research Institute of Hematology and Blood Transfusion, FMBA of Russia, Kirov
    15. Children's Regional Clinical Hospital, Krasnodar
    16. Regional Children's Clinical Hospital, Kursk
    17. Regional Children's Hospital, Lipetsk
    18. Regional Children's Clinical Hospital, Omsk
    19. Regional Children's Clinical Hospital, Orenburg
    20. Perm Regional Children’s Clinical Hospital, Perm
    21. Children's city hospital. Republican Children's Oncohematological Center, Yoshkar-Ola
    22. Children's Republican Clinical Hospital, Ulan-Ude
    23. N.M. Kuraev Children's Republican Clinical Hospital, Ministry of Healthcare of the Republic of Dagestan, Makhachkala
    24. Children's Republican Clinical Hospital, Saransk
    25. Regional Children’s Clinical Hospital, Kazan
    26. Regional Children's Clinical Hospital, Rostov-on-Don
    27. Regional Children's Clinical Hospital, Tambov
    28. Regional Clinical Hospital №1, Tyumen
    29. Regional Children’s Clinical Hospital, Nizhnevartovsk
    30. Regional Children's Clinical Hospital, Chelyabinsk
    31. Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian Federation, Moscow
  • Issue: Vol 20, No 2 (2021)
  • Pages: 84-96
  • Section: ORIGINAL ARTICLES
  • Submitted: 20.05.2021
  • Accepted: 20.05.2021
  • Published: 20.05.2021
  • URL: https://hemoncim.com/jour/article/view/510
  • DOI: https://doi.org/10.24287/1726-1708-2021-20-2-84-96
  • ID: 510

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Abstract

The article presents retrospective data analysis of a cohort of patients with PKD (n = 41 patients, aged 4 months – 26,5 years, median of age – 5 years 1 month) who were examined at the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology for unspecifid hereditary hemolytic anemia during the period 2013–2020. The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. In all patients, the diagnosis was confimed by Next Generation sequencing (NGS). The homozygous mutations in the PKLR gene were found in 10 patients (24.39%), compound heterozygous mutations in 31 patients (75.61%), 77.78% of them were missense mutations. Gender distribution (male:female) was 1:1.73. At least once transfusion of erythrocyte suspension was required to 40 (97.56%) patients. The minimum age at the time of the debut of transfusion dependence was the fist day of life, the maximum was 4 years. Exchange blood transfusion was performed in 13 children, severe normocytic hyperregenerative anemia with transfusion of red blood cells in the fist days of life was noted in 12 children, at the 1st month of life – in 9 children, at the 2nd month of life – in 8 children, at the 3rd month – in 6 children, at the 5th month – in 2 children, at the 1st year – in 1 child, and 2 children underwent single transfusions on the background of infectious episodes at 3 and 4 years respectively. Splenectomy due to high transfusion dependence was performed in 10 patients: transfusion independence was achieved in 5 patients, in 5 – an increase in the interval between blood transfusions. Median of surgical intervention (9 patients): 7 years 4 months, minimum age – 1 year 4 months, maximum – 14 years 4 months. In total, 36 genotypes were described in 41 patients, among them were: c.1529G>A in 3 patients, c.1137_1139del / c.1456C>T – in 2 patients, c.1079G>A/c.1529G>A in 2 patients, c.1130T>C/c.1456C>T in 2 patients, other genotypes occurred once. Two mutations were the most frequent: c.1456C>T (16.67%) and c.1529G>A (16.67%). 19 (46,34%) of patients had previously not described mutations.

About the authors

E. A. Cherniak

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian Federation, Moscow

Author for correspondence.
Email: katerina.chernyak@fccho-moscow.ru

 Ekaterina A. Cherniak, scientifi co-worker of the department of optimizing of treatment of hematological diseases

1179971, Moscow, Samory Mashela st., 1

Russian Federation

N. E. Sokolova

Children's City Multidisciplinary Clinical Specialized Center of High Medical Technologies, Saint-Petersburg

Russian Federation

K. V. Semiglazova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian Federation, Moscow

117997, Москва, ул. Саморы Машела, 1

Russian Federation

I. N. Lavrentyeva

Morozov Children’s City Clinical Hospital, Department of Health in Moscow, Moscow

Russian Federation

E. K. Donush

Russian Children's Clinical Hospital of the N.I. Pirogov Russian National Research Medical University of Ministry of Healthcare of the Russian Federation, Moscow

Russian Federation

O. I. Plaksina

Regional Children's Clinical Hospital, Nizhny Novgorod

Russian Federation

M. V. Borisova

Krasnoyarsk Regional Clinical Center for Maternity and Childhood Protection, Perinatal Center, Krasnoyarsk

Russian Federation

N. A. Danilyuk

Regional Oncological Dispensary, Penza

Russian Federation

E. S. Mitrofanova

Children's Regional Clinical Hospital, Tula

Russian Federation

I. P. Baturskaya

Amur Regional Children's Clinical Hospital, Blagoveshchensk

Russian Federation

N. G. Revina

Regional Children's Clinical Hospital named after P.G. Vyzhletsova, Arkhangelsk

Russian Federation

T. I. Burlutskaya

Children's Regional Clinical Hospital, Belgorod

Russian Federation

M. A. Rakov

Regional Children's Hospital, Bryansk

Russian Federation

A. V. Evstratov

Regional Clinical Children's Hospital, Kaluga

Russian Federation

O. M. Tselousova

Kirov Research Institute of Hematology and Blood Transfusion, FMBA of Russia, Kirov

Russian Federation

V. V. Lebedev

Children's Regional Clinical Hospital, Krasnodar

Russian Federation

N. V. Chaplygina

Regional Children's Clinical Hospital, Kursk

Russian Federation

I. V. Koryakina

Regional Children's Hospital, Lipetsk

Russian Federation

N. S. Osmulskaya

Regional Children's Clinical Hospital, Omsk

Russian Federation

E. I. Afanasyeva

Regional Children's Clinical Hospital, Orenburg

O. E. Nikonova

Perm Regional Children’s Clinical Hospital, Perm

L. I. Sokolova

Children's city hospital. Republican Children's Oncohematological Center, Yoshkar-Ola

E. Kh. Tsedenisheeva

Children's Republican Clinical Hospital, Ulan-Ude

Russian Federation

I. M. Yunusova

N.M. Kuraev Children's Republican Clinical Hospital, Ministry of Healthcare of the Republic of Dagestan, Makhachkala

E. O. Zauralov

Children's Republican Clinical Hospital, Saransk

I. V. Osipova

Regional Children’s Clinical Hospital, Kazan

K. S. Aslanyan

Regional Children's Clinical Hospital, Rostov-on-Don

E. V. Sipacheva

Regional Children's Clinical Hospital, Tambov

O. P. Boldyreva

Regional Clinical Hospital №1, Tyumen

G. R. Kazaryan

Regional Children’s Clinical Hospital, Nizhnevartovsk

E. V. Basharova

Regional Children's Clinical Hospital, Chelyabinsk

S. G. Mann

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian
Federation, Moscow

1179971, Moscow, Samory Mashela st., 1

M. A. Kurnikova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian
Federation, Moscow

1179971, Moscow, Samory Mashela st., 1

E. V. Raikina

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian
Federation, Moscow

1179971, Moscow, Samory Mashela st., 1

N. S. Smetanina

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian
Federation, Moscow

1179971, Moscow, Samory Mashela st., 1

References

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Copyright (c) 2021 Cherniak E.A., Sokolova N.E., Semiglazova K.V., Lavrentyeva I.N., Donush E.K., Plaksina O.I., Borisova M.V., Danilyuk N.A., Mitrofanova E.S., Baturskaya I.P., Revina N.G., Burlutskaya T.I., Rakov M.A., Evstratov A.V., Tselousova O.M., Lebedev V.V., Chaplygina N.V., Koryakina I.V., Osmulskaya N.S., Afanasyeva E.I., Nikonova O.E., Sokolova L.I., Tsedenisheeva E.K., Yunusova I.M., Zauralov E.O., Osipova I.V., Aslanyan K.S., Sipacheva E.V., Boldyreva O.P., Kazaryan G.R., Basharova E.V., Mann S.G., Kurnikova M.A., Raikina E.V., Smetanina N.S.

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