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Updated: Jan 23, 2026

Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
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Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management

Published on: January 19, 2024

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[Acquired aplastic anemia]

Kohei Hosokawa1, Shinji Nakao1

  • 1Department of Hematology, Kanazawa University Hospital.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|June 7, 2019
PubMed

Acquired aplastic anemia (AA) is a hematopoietic disorder caused by an immunologic attack on hematopoietic stem cells (HSCs). The presence of cells with a paroxysmal nocturnal hemoglobinuria (PNH) phenotype or with copy-number neutral loss of heterozygosity of chromosome 6p (6pLOH) suggests an immune-mediated pathophysiology underlying AA. Recently, genomic studies have revealed clonal hematopoiesis by HSCs with altered genes. PIGA, DNMT3A, ASXL1, BCOR, 6pLOH, and HLA class I allele mutations are common in patients with AA. The genomic landscape of AA is distinct from that of the myelodysplastic syndrome or age-related clonal hematopoiesis. This suggests that escape from an autoimmune attack is strongly associated with clonal hematopoiesis in AA. Eltrombopag (EPAG), a thrombopoietin receptor agonist, has recently emerged as a novel therapeutic agent for AA. Further studies are needed to clarify whether EPAG induces clonal expansion of these clones.

Keywords:
Aplastic anemiaClonal hematopoiesisEltrombopagEscape hematopoiesis

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