Clonal Evolution of Aplastic Anemia: A Brief Literature Review and a Case Report

AUTOIMMUNE THROMBOCYTOPENIA , ,

ER Shilova1, TV Glazanova1, II Kostroma1, MN Zenina1,2, OE Rozanova1, ZhV Chubukina1, RR Sabitova1, NA Romanenko1, VA Balashova1, SV Gritsaev2

1 Russian Research Institute of Hematology and Transfusiology, 16 2-ya Sovetskaya ul., Saint Petersburg, Russian Federation, 191024

2 II Mechnikov North-Western State Medical University, 41 Kirochnaya ul., Saint Petersburg, Russian Federation, 191015

For correspondence: Elena Romanovna Shilova, MD, PhD, 16 2-ya Sovetskaya ul., Saint Petersburg, Russian Federation, 191024; Tel.: +7(981)129-09-77, +7(812)717-08-90; e-mail: rniiht@mail.ru

For citation: Shilova ER, Glazanova TV, Kostroma II, et al. Clonal Evolution of Aplastic Anemia: A Brief Literature Review and a Case Report. Clinical oncohematology. 2022;15(3):298–306. (In Russ).

DOI: 10.21320/2500-2139-2022-15-3-298-306

ABSTRACT

Aplastic anemia (AA) is a non-neoplastic hematological disease closely associated with bone marrow failure which is typical of paroxysmal nocturnal hemoglobinuria (PNH) and myelodysplastic syndrome (MDS). The PNH clones can be detected in more than a half of AA patients at onset of the disease, and there is a probability for AA/PNH co-variants to progress to classic hemolytic PNH. At the same time, the AA patients treated by immunosuppressive therapy undergo the risk of disease transformation to MDS and acute myeloid leukemia. Currently known risk factors and possible precursors of such transformation are considered in the brief literature review. In addition to that, the paper provides a case report of AA/PNH transformation to MDS during complete AA remission after immunosuppressive therapy combined with a successful haploidentical transplantation of hematopoietic stem cells.

Keywords: aplastic anemia, myelodysplastic syndrome, paroxysmal nocturnal hemoglobinuria, immunosuppressive therapy, haploidentical transplantation of hematopoietic stem cells.

Received: January 28, 2022

Accepted: May 17, 2022

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