{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:33:33Z","timestamp":1790732013433,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T00:00:00Z","timestamp":1548374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Novel therapies in development have brought a new focus on pyruvate kinase deficiency (<jats:styled-content style=\"fixed-case\">PKD<\/jats:styled-content>), the most common congenital haemolytic anaemia due to a glycolytic enzyme deficiency. With an improved recognition of its clinical presentation and understanding of the diagnostic pathway, more patients are likely to be identified with this anaemia. Complications, including gallstones and non\u2010transfusion\u2010related iron overload, require monitoring for early diagnosis and management. Current management remains supportive with red cell transfusions, chelation and splenectomy. Decisions to transfuse and\/or splenectomise must be individualised. Haematopoietic stem cell transplant has been pursued in a small number of patients with mixed outcomes. Novel treatment approaches, which range from a small molecule pyruvate kinase activator to gene therapy, may transform the way in which <jats:styled-content style=\"fixed-case\">PKD<\/jats:styled-content> is managed in the future. In this review, we discuss the pathophysiology of <jats:styled-content style=\"fixed-case\">PKD<\/jats:styled-content> and present our approaches to diagnosis, monitoring and management of patients with this anaemia.<\/jats:p>","DOI":"10.1111\/bjh.15758","type":"journal-article","created":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T14:07:23Z","timestamp":1548425243000},"page":"721-734","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["How we manage patients with pyruvate kinase deficiency"],"prefix":"10.1111","volume":"184","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7302-0449","authenticated-orcid":false,"given":"Rachael F.","family":"Grace","sequence":"first","affiliation":[{"name":"Dana\u2010Farber\/Boston Children's Cancer and Blood Disorders Center Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Mark 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