How I treat acquired aplastic anemia

AcquiredSAAis regardedas the resultof an immune-mediateddestruction of hematopoietic cells, at least in a proportion of patients. The emergence of late clonal disorders in10%to20%ofpatients after immunosuppressive therapy (IST) raises the questions of whether some patients with SAA actually have a premalignant disease and whether IST is just postponing the inevitable. Support for this view has come from the identification of somatic mutations involving telomerase RNA component (TERC) and telomerase reverse transcriptase (TERT) and, more recently, involving myeloid cancer candidate genes in a significant proportion of patients.