Acquired disorders/conditions associated with increased fetal hemoglobin (Hb F)

Developmental

Prematurity

Infants of diabetic mothers

Trisomy 13

Bone marrow regeneration/increased erythropoiesis

After acute blood loss

After iron replacement in severe iron deficiency

Following chemotherapy

Following hematopoietic stem cell transplant

Acute hemolysis

Transient erythroblastopenia of childhood (TEC)

Pregnancy-associated erythroid expansion

Inherited bone marrow failure syndromes

Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome

Malignancies

Juvenile myelomonocytic leukemia (JMML)

Other hematologic malignancies (AML, MDS, erythroleukemia, ALL, CML)

Solid tumors (choriocarcinoma, adenocarcinoma of the lung, hepatoma)

Refer to UpToDate for additional discussion of the causes and mechanisms of increased Hb F.

AML: acute myeloid leukemia; MDS: myelodysplastic syndrome; ALL: acute lymphocytic leukemia; CML: chronic myelogenous leukemia.

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