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December 8, 2025BloodOpen Access

Spontaneous remissions in paroxysmal nocturnal hemoglobinuria: True remission or clonal evolution to malignancy?

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Authors

MHMatthew T. HoltLALouise ArnoldLMLindsay Mitchell

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Overview

Retrospective analysis reveals spontaneous remission in PNH patients may indicate clonal evolution, implying continued monitoring is crucial.

Key Points

  • Spontaneous remission occurs in a small subset of paroxysmal nocturnal hemoglobinuria patients, indicating potential underlying risks.
  • 5 patients (17.9%) showed evidence of clonal evolution, underscoring the importance of post-treatment surveillance.
  • Anti-complement therapy with eculizumab is central to managing PNH, though discontinuation requires careful monitoring.
  • Bone marrow assessments are essential to distinguish true remission from clonal evolution, guiding future treatment decisions.

Cite This Study

Holt et al. (2025) studied this question.

synapsesocial.com/papers/69362f7f4fa91c937236e5f1https://doi.org/10.1182/blood-2025-29
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Correlation between efficacy, clonal dynamics evolution, and development of bone marrow failure in PNH/AA syndrome treated with complement inhibitors: A single-center cohort study2025
  2. 2Treatment-requiring paroxysmal nocturnal hemoglobinuria in association with myeloproliferative neoplasms (MPNs): Clinical correlations and outcomes2025
  3. 3The role of red blood cell lifespan in evaluating the condition of patients with paroxysmal nocturnal hemoglobinuria treated with complement inhibitors2025
  4. 4A diagnostic pivot: Paroxysmal nocturnal hemoglobinuria mimicking refractory immune thrombocytopenia in an elderly woman with autoimmune comorbidities2025
  5. 5Real-world data on breakthrough hemolysis in patients with paroxysmal nocturnal hemoglobinuria treated with proximal and terminal complement inhibitors.2025