The pathogenesis, diagnosis and management of congenital dyserythropoietic anaemia type I

Br J Haematol. 2019 May;185(3):436-449. doi: 10.1111/bjh.15817. Epub 2019 Mar 5.


Congenital dyserythropoietic anaemia type I (CDA-I) is one of a heterogeneous group of inherited anaemias characterised by ineffective erythropoiesis. CDA-I is caused by bi-allelic mutations in either CDAN1 or C15orf41 and, to date, 56 causative mutations have been documented. The diagnostic pathway is reviewed and the utility of genetic testing in reducing the time taken to reach an accurate molecular diagnosis and avoiding bone marrow aspiration, where possible, is described. The management of CDA-I patients is discussed, highlighting both general and specific measures which impact on disease progression. The use of interferon alpha and careful management of iron overload are reviewed and suggest the most favourable outcomes are achieved when CDA-I patients are managed with a holistic and multidisciplinary approach. Finally, the current understanding of the molecular and cellular pathogenesis of CDA-I is presented, highlighting critical questions likely to lead to improved therapy for this disease.

Keywords: anaemia; clinical haematology; congenital dyserythropoetic anaemia; dyserythropoiesis; erythropoiesis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alleles*
  • Anemia, Dyserythropoietic, Congenital / diagnosis
  • Anemia, Dyserythropoietic, Congenital / genetics
  • Anemia, Dyserythropoietic, Congenital / metabolism
  • Anemia, Dyserythropoietic, Congenital / therapy
  • Genetic Testing*
  • Glycoproteins / genetics*
  • Glycoproteins / metabolism
  • Humans
  • Interferon-alpha / therapeutic use*
  • Iron Overload / diagnosis
  • Iron Overload / genetics
  • Iron Overload / metabolism
  • Iron Overload / prevention & control
  • Mutation*
  • Nuclear Proteins / genetics*
  • Nuclear Proteins / metabolism


  • CDAN1 protein, human
  • Glycoproteins
  • Interferon-alpha
  • Nuclear Proteins