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Prepublished online as a Blood First Edition Paper on March 6, 2003; DOI 10.1182/blood-2003-01-0128.

Submitted January 17, 2003
Accepted February 24, 2003
Severe telomere shortening affects both GPI- and GPI+ hematopoiesis in patients with paroxysmal nocturnal hemoglobinuria
Anastasios Karadimitris, David J Araten, Lucio Luzzatto*, and Rosario Notaro
Department of Human Genetics and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
Department of Hematology, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom
Laboratorio di Genetica Umana, Dipartimento di Eziologia ed Epidemiologia, IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
* Corresponding author; email: lucio.luzzatto{at}istge.it.
A most distinctive feature of paroxysmal nocturnal hemoglobinuria (PNH) is that in each patient GPI- and GPI+ hematopoietic stem cells (HSC) co-exist, and both contribute to hematopoiesis. Telomere size correlates inversely with the cell division history of HSC. In 10 patients with hemolytic PNH the telomeres in sorted GPI- granulocytes were shorter than in sorted GPI+ granulocytes in 4 cases, comparable in 2 cases, and longer in the remaining 4 cases. Furthermore, the telomeres of both GPI- and GPI+ hematopoietic cells were markedly shortened compared to age-matched controls. The short telomeres in the GPI- cells probably reflect the large number of cell divisions required for the progeny of a single cell to contribute a large proportion of hematopoiesis. The short telomeres of the GPI+ cells indicate that the residual hematopoiesis contributed by these cells is not normal. This epigenetic change is an additional feature shared by PNH and aplastic anemia.

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