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Review
. 2023 Dec 8;2023(1):556-562.
doi: 10.1182/hematology.2023000489.

Management of Fanconi anemia beyond childhood

Affiliations
Review

Management of Fanconi anemia beyond childhood

Timothy S Olson. Hematology Am Soc Hematol Educ Program. .

Abstract

Fanconi anemia (FA) has long been considered a severe inherited bone marrow failure (BMF) disorder of early childhood. Thus, management of this multisystem disorder has previously been unfamiliar to many hematologists specializing in the care of adolescents and young adults (AYA). The increased diagnosis of FA in AYA patients, facilitated by widely available germline genomic testing, improved long-term survival of children with FA following matched sibling and alternative donor hematopoietic stem cell transplantation (HSCT) performed for BMF, and expanding need in the near future for long-term monitoring in patients achieving hematologic stabilization following ex vivo gene therapy are all reasons why management of FA in AYA populations deserves specific consideration. In this review, we address the unique challenges and evidence-based practice recommendations for the management of AYA patients with FA. Specific topics addressed include hematologic monitoring in AYA patients yet to undergo HSCT, management of myeloid malignancies occurring in FA, diagnosis and management of nonhematologic malignances and organ dysfunction in AYA patients with FA, and evolving considerations for the long-term monitoring of patients with FA undergoing gene therapy.

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Conflict of interest statement

Timothy S. Olson: no competing financial interests to declare.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Schematic of leukemic transformation pathways in patients with Fanconi anemia.

References

    1. Dufour C, Pierri F.. Modern management of Fanconi anemia. Hematology Am Soc Hematol Educ Program. 2022;2022(1):649-657. doi:10.1182/hematology.2022000393. - DOI - PMC - PubMed
    1. Fanconi Anemia Clinical Care Guidelines. 5th ed. Fanconi Anemia Research Fund; Eugene, OR, 2020.
    1. Sevilla J, Navarro S, Rio P, et al.. Improved collection of hematopoietic stem cells and progenitors from Fanconi anemia patients for gene therapy purposes. Mol Ther Methods Clin Dev. 2021;22:66-75. doi:10.1016/j.omtm.2021.06.001. - DOI - PMC - PubMed
    1. Brosh RM, Bellani M, Liu Y, Seidman MM. Fanconi Anemia: a DNA repair disorder characterized by accelerated decline of the hematopoietic stem cell compartment and other features of aging. Ageing Res Rev. 2017;33:67-75. doi:10.1016/j.arr.2016.05.005. - DOI - PMC - PubMed
    1. Hira A, Yabe H, Yoshida K, et al.. Variant ALDH2 is associated with accelerated progression of bone marrow failure in Japanese Fanconi anemia patients. Blood. 2013;122(18):3206-3209. doi:10.1182/blood-2013-06-507962. - DOI - PMC - PubMed