Osteogenic sarcoma associated with Diamond-Blackfan anemia: a report from the Diamond-Blackfan Anemia Registry.
OBJECTIVE
Diamond-Blackfan anemia (DBA) is a congenital pure red cell aplasia, usually presenting in infancy or early childhood. A review of the literature strongly supports a predisposition to hematopoietic malignancy. Recently, solid tumors have been reported, some attributable to hemosiderosis and/or androgen therapy. Two cases of osteogenic sarcoma have also been documented. An analysis from the Diamond-Blackfan Anemia Registry was performed to evaluate the cancer risk in patients with DBA.


METHODS
The Diamond-Blackfan Anemia Registry of North America (DBAR) is a comprehensive database of patients with DBA enrolled, after informed consent, through outreach to pediatric hematologists and family groups. The patients and/or their families complete a detailed questionnaire, and a review of medical records and telephone interviews are performed to complete and clarify the information provided.


RESULTS
Of the 354 patients registered in the DBAR, there were six patients meeting the accepted diagnostic criteria for DBA who were found to have malignancies. Three patients had osteogenic sarcoma diagnosed, one with myelodysplastic syndrome, one with colon carcinoma, and one with a soft tissue sarcoma.


CONCLUSIONS
There appears to be an association of osteogenic sarcoma with DBA. A young age at presentation may be a feature of DBA-associated osteogenic sarcoma. Because of the immaturity of the database, the actuarial risk for osteogenic sarcoma and other cancers in individuals with DBA cannot be ascertained. Speculation is made regarding the nature of the molecular defect leading to the association of DBA and osteogenic sarcoma.
Lipton
J M
JM
Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Schneider Children's Hospital, Albert Einstein College of Medicine at the Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA. jlipton@lij.edu
Federman
N
N
Khabbaze
Y
Y
Schwartz
C L
CL
Hilliard
L M
LM
Clark
J I
JI
Vlachos
A
A
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000150:complications / Q000453:epidemiology*; D002675:Child, Preschool; D003110:Colonic Neoplasms / Q000150:complications; D016208:Databases, Factual; D004198:Disease Susceptibility; D005199:Fanconi Anemia / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009190:Myelodysplastic Syndromes / Q000150:complications; D012516:Osteosarcoma / Q000150:complications / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D012509:Sarcoma / Q000150:complications; D014481:United States