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Zhang Q, Huo Y, Sun Q, Liu N, Shi H, Wang M, Xiao J, Yuan H, Tang X. Case report: Curing a rare, unstable hemoglobin variant Hb Bristol-Alesha using haploidentical hematopoietic stem cell transplantation. Front Immunol 2023; 14:1188058. [PMID: 37457725 PMCID: PMC10348747 DOI: 10.3389/fimmu.2023.1188058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Unstable hemoglobinopathies are a rare, heterogeneous group of diseases that disrupt the stability of hemoglobin (Hb), leading to chronic hemolysis and anemia. Patients with severe phenotypes often require regular blood transfusions and iron chelation therapy. Although rare, studies have reported that hematopoietic stem cell transplantation (HSCT) seems to be an available curative approach in transfusion-dependent patients with unstable hemoglobinopathies. Here, we describe successful haploidentical HSCT for the treatment of an unstable Hb variant, Hb Bristol-Alesha, in a 6-year-old boy with severe anemia since early childhood. Two years after transplantation, he had a nearly normal hemoglobin level without evidence of hemolysis. DNA analysis showed complete chimerism of the donor cell origin, confirming full engraftment with normal erythropoiesis.
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Affiliation(s)
- Qin Zhang
- Department of Hematology, No.971 Hospital of People's Liberation Army Navy, Qingdao, Shandong, China
| | - Yujia Huo
- Department of Traditional Chinese Medicine, Qingdao Special Service Sanatorium of People's Liberation Army Navy, Qingdao, Shandong, China
| | - Qinggang Sun
- Department of Hematology, No.971 Hospital of People's Liberation Army Navy, Qingdao, Shandong, China
| | - Nan Liu
- Department of Hematology, No.971 Hospital of People's Liberation Army Navy, Qingdao, Shandong, China
| | - Hongchuan Shi
- Department of Hematology, No.971 Hospital of People's Liberation Army Navy, Qingdao, Shandong, China
| | - Minghui Wang
- Department of Hematology, No.971 Hospital of People's Liberation Army Navy, Qingdao, Shandong, China
| | - Jinming Xiao
- Department of Hematology, No.971 Hospital of People's Liberation Army Navy, Qingdao, Shandong, China
| | - Hanzi Yuan
- Department of Pediatrics, the Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
| | - Xiangfeng Tang
- Department of Pediatrics, the Seventh Medical Center of People's Liberation Army General Hospital, Beijing, China
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Li S, Chen K, Huang C, Zhang N, Jiang H, Jiang S. First report of successful treatment for hemoglobin Bristol-Alesha by hemopoietic stem cell transplantation. Ann Hematol 2021; 101:617-619. [PMID: 34851438 DOI: 10.1007/s00277-021-04721-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 11/03/2021] [Indexed: 12/01/2022]
Abstract
HBB gene mutations lead to many kinds of diseases, of which, except for the two most common diseases of thalassemia and sickle cell anemia, rare kinds of hemolytic anemia, such as hemoglobin Bristol-Alesha, are rarely reported, no ideal treatment in clinic. A child suffered from chronic recurrent hemolytic attacks and the related genes of hereditary hemolytic anemia were detected on her. Hematopoietic stem cell transplantation was conducted in the treatment of the patient. The patient was diagnosed as hemoglobin Bristol-Alesha and achieved complete recovery after hematopoietic stem cell transplantation. For Bristol-Alesha, without characteristic clinical manifestation and specific biochemical examination, diagnosis is dependent on the gene mutation detection and hematopoietic stem cell transplantation is an effective and curable method.
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Affiliation(s)
- Shanshan Li
- Department of Hematology of Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Kai Chen
- Department of Hematology of Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Can Huang
- Department of Hematology of Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Na Zhang
- Department of Hematology of Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Hui Jiang
- Department of Hematology of Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
| | - Shayi Jiang
- Department of Hematology of Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
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Zhang Q, Shi HC, Liu N. [Hb Alesha of unstable hemoglobinopathy: a case report and literature review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 42:158-160. [PMID: 33858048 PMCID: PMC8071674 DOI: 10.3760/cma.j.issn.0253-2727.2021.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Q Zhang
- Department of Hematology, No.971 Hospital of PLA Navy, Qingdao 266071, China
| | - H C Shi
- Department of Hematology, No.971 Hospital of PLA Navy, Qingdao 266071, China
| | - N Liu
- Department of Hematology, No.971 Hospital of PLA Navy, Qingdao 266071, China
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Su Q, Chen S, Wu L, Tian R, Yang X, Huang X, Chen Y, Peng Z, Chen J. Severe Thalassemia Caused by Hb Zunyi [β147(HC3)Stop→Gln; HBB: c.442T>C)] on the β-Globin Gene. Hemoglobin 2019; 43:7-11. [PMID: 31084366 DOI: 10.1080/03630269.2019.1582430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Hemoglobinopathies are caused by genetic defects on the globin genes. To date, more than 900 β-globin variants have been recorded worldwide. These gene alterations often cause either a decrease in β-globin synthesis or completely block synthesis, leading to a hemoglobinopathy. While most of these causative mutations are inherited, de novo mutations are quite rare. Here, we investigated three hemoglobinopathy cases. These patients developed severe hemolytic anemia at 3-5 months of age and were transfusion-dependent. In patient 1, a novel β variant, Hb Zunyi [β147(HC3)Stop→Gln; HBB: c.442T>C] was identified. This de novo mutation results in a stop codon substitution to a glutamine residue at codon 147 of the β-globin gene, and leads to severe thalassemia. In patient 2, we discovered the rare Hb Southampton mutation [β106(G8)Leu→Pro; HBB: c.320T>C], while in patient 3, the rare Hb Alesha mutation [β67(E11)Val→Met (GTG>ATG); HBB: c.202G>A] was detected. The identification of the novel β variant, Hb Zunyi, has added to the human globin database and will shed light on future diagnosis of hemoglobinopathy/thalassemia and genetic counseling.
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Affiliation(s)
- Qiong Su
- a The Second Department of Pediatrics , Affiliated Hospital of Zunyi Medical University , Zunyi , GuiZhou Province , People's Republic of China.,e Zunyi Medical and Pharmaceutical College , Zunyi , GuiZhou Province , People's Republic of China
| | - Shiping Chen
- b Beijing Genomics Institute (BGI) Shenzhen , Shenzhen , Guangdong Province , People's Republic of China
| | - Liusong Wu
- a The Second Department of Pediatrics , Affiliated Hospital of Zunyi Medical University , Zunyi , GuiZhou Province , People's Republic of China
| | - Runmei Tian
- a The Second Department of Pediatrics , Affiliated Hospital of Zunyi Medical University , Zunyi , GuiZhou Province , People's Republic of China
| | - Xiaoqin Yang
- b Beijing Genomics Institute (BGI) Shenzhen , Shenzhen , Guangdong Province , People's Republic of China
| | - Xiaoyan Huang
- b Beijing Genomics Institute (BGI) Shenzhen , Shenzhen , Guangdong Province , People's Republic of China
| | - Yan Chen
- a The Second Department of Pediatrics , Affiliated Hospital of Zunyi Medical University , Zunyi , GuiZhou Province , People's Republic of China
| | - Zhiyu Peng
- b Beijing Genomics Institute (BGI) Shenzhen , Shenzhen , Guangdong Province , People's Republic of China
| | - Jindong Chen
- c Department of Urology , University of Rochester Medical Center , Rochester , NY USA.,d Department of Medical Genetics , Zunyi Medical University , Zunyi , GuiZhou Province , People's Republic of China
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