Minor PNH clones do not distinguish inherited bone marrow failure syndromes from immune-mediated aplastic anemia
Atsushi Narita, Shunsuke Miwata, Masayuki Imaya, Yusuke Tsumura, Ayako Yamamori, Manabu Wakamatsu, Motoharu Hamada, Rieko Taniguchi, Yusuke Okuno, Hideki Muramatsu, Yoshiyuki Takahashi
Abstract
An article by Shah et al 1 discusses the predictive value of paroxysmal nocturnal hemoglobinuria (PNH) clones in diagnosing bone marrow failure (BMF). The authors investigated 454 patients with aplastic anemia (AA), inherited BMF syndromes (IBMFSs), or other hematologic diseases and concluded that PNH clones could be used to distinguish AA from IBMFSs. However, very small PNH clones (about 22 per million cells on average) can also be detected in the granulocytes of healthy individuals, 2 and the authors based their conclusions on the observation that the PNH clone was not detected in a small number of 22 patients with IBMFSs and other hematologic diseases.