The following is a summary of “Prognostic value of pre-treatment PNH clone among the patients with aplastic anemia: a meta-analysis,” published in the May 2023 issue of Hematology by Li, et al.
The presence of a paroxysmal nocturnal hemoglobinuria (PNH) clone in patients with aplastic anemia (AA) before treatment is a subject of interest. However, the prognostic value of pre-treatment PNH clones for intensive immunosuppressive therapy (IIST) remains controversial, and there is no consensus on its relationship with the development of PNH/AA-PNH syndrome. For a study, researchers sought to summarize the prognostic value of pre-treatment PNH clones in AA patients treated with IIST and to explore its association with the occurrence of PNH/AA-PNH syndrome.
A systematic review was conducted to identify relevant studies on the prognostic value of pre-treatment PNH clones in AA patients. The analysis included pooled odds ratios (OR) with corresponding 95% CI and p-values to assess the statistical significance of the results.
Fifteen studies comprising a total of 1,349 patients were included in the meta-analysis. The presence of pre-treatment PNH clone showed a positive effect on AA patients in terms of the 6-month (pooled OR = 1.49, 95% CI: 1.06-2.08, P = 0.020), 12-month (pooled OR = 3.10, 95% CI: 1.89-5.10, P = 0.000), and overall hematological response rates (pooled OR = 1.69, 95% CI: 1.07-2.68, P = 0.024) after IIST. Furthermore, patients with pre-treatment PNH clones were more likely to develop PNH/AA-PNH syndrome after IIST (pooled OR = 2.78, 95% CI: 1.21-6.39, P = 0.016).
AA patients with a positive pre-treatment PNH clone demonstrated better hematological responses to IIST compared to those without the clone. Additionally, these patients had an increased likelihood of developing PNH/AA-PNH syndrome following IIST.