What does the presence of paroxysmal nocturnal hemoglobinuria (PNH) clones indicate in patients with aplastic anemia treated with immunosuppressive therapy (IST)?

Updated: Jan 29, 2021
  • Author: Sameer Bakhshi, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Up to 50% of patients with aplastic anemia demonstrate small paroxysmal nocturnal hemoglobinuria (PNH) clones in the absence of evidence of hemolysis. [5] Some, but not all, studies have found evidence that the presence of a PNH clone predicts a better response to immunosuppressive therapy. Patients with a significant PNH clone who are receiving immunosuppressive therapy, especially ATG, should be actively monitored for signs of hemolysis. In patients with a history of PNH-associated thrombosis, use of ATG is not recommended.


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