Detection of paroxysmal nocturnal hemoglobinuria clones to exclude inherited bone marrow failure syndromes

Eur J Haematol. 2014 Jun;92(6):467-70. doi: 10.1111/ejh.12299. Epub 2014 Mar 18.

Abstract

Background: Inherited bone marrow failure syndromes (IBMFS) and acquired aplastic anemia (AA) are life-threatening marrow failure disorders. These entities can be difficult to distinguish because they present similarly. Correct diagnosis is imperative for proper therapy.

Design and methods: This is a retrospective, single-center study of patients <40 yr of age, evaluated for bone marrow failure, and assayed for the presence of a PNH clone in the pediatric or adult hematology/oncology clinics from 2001 to present. Patients were also evaluated for IBMFS.

Results: We present results from 156 patients with marrow failure, 20 of whom have IBMFS. None of the IBMSF patients had paroxysmal nocturnal hemoglobinuria (PNH) clones.

Conclusions: Although further studies are needed, our results suggest that the detection of a PNH clone can be a useful diagnostic tool to exclude the diagnosis of IBMFS and focus the work-up and treatment on an acquired form of marrow failure.

Keywords: aplastic anemia; bone marrow failure; inherited marrow failure; pancytopenia; paroxysmal nocturnal hemoglobinuria.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Anemia, Aplastic
  • Bone Marrow / pathology
  • Bone Marrow Diseases
  • Bone Marrow Failure Disorders
  • Child
  • Child, Preschool
  • Clonal Evolution*
  • Diagnosis, Differential
  • Female
  • Hemoglobinuria, Paroxysmal / diagnosis*
  • Hemoglobinuria, Paroxysmal / genetics
  • Hemoglobinuria, Paroxysmal / pathology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Young Adult