A new diagnostic tool, the Predictive Aplastic Score System (PASS), accurately distinguishes acquired aplastic anemia from inherited bone marrow failure syndromes using routine clinical data.
Acquired aplastic anemia can mimic inherited bone marrow failure syndromes, complicating treatment decisions. Current diagnostic methods often rely on excluding inherited conditions, but genetic testing can be inaccessible, delayed, or inconclusive.
Researchers developed PASS to differentiate these conditions in adults using readily available clinical variables. The model identified seven key variables: severity, acuity, age, inherited syndrome red flags, associated conditions, somatic changes, and telomere length.
In training, the PASS model achieved an area under the curve of 0.990. Scores of 30 or above showed a 100% positive predictive value for acquired aplastic anemia. The model was validated externally on 716 patients, maintaining high accuracy with an area under the curve of 0.977.
PASS offers clinicians a rapid and reliable alternative when genetic testing is unavailable or delayed. An open-access web-based calculator has been developed to support its clinical adoption.