Myelodysplastic Syndrome and Acute Myelogenous Leukemia as a Late Clonal Complication in Children With Acquired Aplastic Anemia

Author:

Ohara Akira1,Kojima Seiji1,Hamajima Nobuyuki1,Tsuchida Masahiro1,Imashuku Shinsaku1,Ohta Shigeru1,Sasaki Hideki1,Okamura Jun1,Sugita Kanji1,Kigasawa Hisato1,Kiriyama Yukio1,Akatsuka Junichi1,Tsukimoto Ichiro1

Affiliation:

1. From the Aplastic Anemia Committee of the Japanese Society of Pediatric Hematology.

Abstract

Abstract The improved outcome of acquired aplastic anemia (AA) has revealed later complications, such as myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML). We retrospectively analyzed 167 children with severe acquired AA. Eleven of 50 children treated with cyclosporin (CSA) and recombinant human granulocyte colony-stimulating factor (rhG-CSF ) developed MDS/AML; 8 of these were within 36 months of the diagnosis of AA, much earlier than previous reports. Six of the 11 children received rhG-CSF exceeding 10 μg/kg/d, and 9 received rhG-CSF therapy for over 1 year. Ten children showed monosomy 7 at diagnosis of MDS. All of the 11 children were administered both CSA and rhG-CSF. There was no development of MDS/AML among 41 children treated with either CSA or rhG-CSF or among 48 children who underwent bone marrow transplantation. A well-controlled clinical trial is warranted to determine whether therapeutic modalities affect the development of MDS/AML in children with severe acquired AA.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

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