Clonality of acquired primary pure red cell aplasia

✍ Scribed by Masuda, Michihiko; Saitoh, Hiroshi; Mizoguchi, Hideaki

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 52 KB
• Volume: 62
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/(sici)1096-8652(199911)62:3<193::aid-ajh10>3.0.co;2-d

✦ Synopsis

Acquired primary pure red cell aplasia (PRCA) has frequently been shown to be associated with T cells that inhibit marrow erythropoiesis. A 41-year-old female presented with anemia in December 1985. Bone marrow examination revealed 1.8% erythroid cells. A diagnosis of PRCA was made. She received prednisolone, and her hemoglobin level recovered to 12 g/dl. In February 1995, her hemoglobin level decreased to 5.8 g/dl, and acquired primary PRCA recurred. Surface markers of peripheral blood mononuclear cells demonstrated CD4/8 ratio inversion. The T-cell receptor (TCR)-␤ chain gene showed germ line configuration by Southern blot analysis of the mononuclear cells in peripheral blood. However, stepdown polymerase chain reaction analysis revealed that the TCR-␤ gene of peripheral blood mononuclear cells was rearranged. With highly sensitive polymerase chain reaction analysis, clonality of T cells was confirmed. We propose that some acquired primary PRCA patients have a T-cell clonal disorder, similar to some PRCA patients with large granular lymphocytes leukemia or thymoma.