Significance of the detection of paroxysmal nocturnal hemoglobinuria clones in patients with multiple myeloma undergoing autologous stem cell transplantation

Abstract

We confirmed findings of previous reports with current diagnostic guidelines and showed that although the size of the clones may be relatively large, their presence is probably not detrimental. The clinical significance of these clones and the possible mechanisms underlying their expansion in MM must be a subject of further investigation.

Erythrocyte deformability profile evaluated by laser diffractometry in patients with multiple myeloma: Re-examination of our cases

“…An alternative hypothesis might be the presence of a paroxysmal nocturnal hemoglobinuria-like (PNH-like) defect in the erythrocyte membrane of MM patients [42][43][44]; the percentage of this laboratory finding, up to now, is more variable. In fact, while in the paper of Varma [45] this percentage was by 6.89%, in those of Meletis [43] and of Chatziantoniou [42] were respectively by 9.6% and 32.3% of the examined MM patients. Moreover, Terpos [44] studied 43 MM patients and detected this alteration in 56% of his group.…”

Dapsone-Induced Hemolytic Anemia in Multiple Myeloma: Case Report of Various Differential Diagnoses

“…MM-associated hemolysis can be divided into the following: intramedullary PC-associated erythrocyte destruction or defective erythropoiesis, [5][6][7][8] MM-associated autoreactive antibodies, 3,[9][10][11][12][13][14][15][16] or drug-induced hemolysis. [17][18][19][20] Malignant PCs can induce hemolysis by diverse mechanisms: dysregulated PC apoptosis may elicit erythroblast cytotoxicity, or occasionally malignant PC phagocyte erythrocytes.…”

“…5,7,21 Furthermore, MM can be associated with congenital diseases like dyserythropoietic anemia type III, glucose-6-phosphate dehydrogenase deficiency, or secondary paroxysmal nocturnal hemoglobinuria. 6,22,23 Hemolysis in MM may also be based on an immunoglobulin inducing autoimmune hemolytic anemia (AIHA). 3,10 These antibodies are more often of warm rather than cold type, 9,15,24 and might constitute the M proteins themselves.…”

Thrombotic risk in paroxysmal nocturnal hemoglobinuria-like (PNH-like) phenotype

“…Some data are available in the literature regarding the presence of PNH phenotype in red blood cells of patients with PCD diagnosis [51,52]. Meletis et al described the presence of CD55/CD59-deficient red cells in patients with PCD, including monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma with IgA, IgG, IgD, BJ, Non-secretory isotypes and Heavy chain disease (HCD) [53].…”