Risk factors for evolution of acquired aplastic anemia into myelodysplastic syndrome and acute myeloid leukemia after immunosuppressive therapy in children

DOI PDF 被引用文献17件
  • Seiji Kojima
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Akira Ohara
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Masahiro Tsuchida
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Toru Kudoh
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Ryoji Hanada
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Yuri Okimoto
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Takashi Kaneko
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Toshikuni Takano
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Koichiro Ikuta
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.
  • Ichiro Tsukimoto
    From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group.

抄録

<jats:title>Abstract</jats:title> <jats:p>Long-term survivors of acquired aplastic anemia (AA) have an increased risk of developing myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) after immunosuppressive therapy (IST). It is uncertain whether the increased survival time simply discloses the natural history of AA as a premalignant disease or whether secondary disease is related to the therapy itself. Between November 1992 and September 1997, 113 AA children with normal cytogenetics at diagnosis were treated with IST using antithymocyte globulin, cyclosporin, and danazol with or without granulocyte colony-stimulating factor (G-CSF). We assessed risk factors for developing MDS/AML by Cox proportional hazards models. Twelve of 113 patients developed MDS between 9 and 81 months following the time of diagnosis, giving a cumulative incidence of 13.7 ± 3.9%. The following cytogenetic abnormalities were observed at the time of diagnosis of MDS: monosomy 7 (6 patients), monosomy7/trisomy21 (1 patient), trisomy 11 (1 patient), del (11) (9?:14) (1 patient), add (9q) (1 patient), add 7 (q 32) (1 patient), and trisomy 9 (1 patient). The number of days of G-CSF therapy and nonresponse to therapy at 6 months were statistically significant risk factors by multivariate analysis. The present study suggests a close relationship between long-term use of G-CSF and secondary MDS in nonresponders to IST.</jats:p>

収録刊行物

  • Blood

    Blood 100 (3), 786-790, 2002-08-01

    American Society of Hematology

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