Difference in clinical features between Japanese and German patients with refractory anemia in myelodysplastic syndromes.
Several reports indicate that there might be differences in clinical features between Asian and Western myelodysplastic syndrome (MDS) cases. We analyzed refractory anemia (RA) in French-American-British (FAB) classification cases diagnosed in Japan and Germany to perform a more exact comparison between Asian and Western MDS types. In the first step, we analyzed agreement of morphologic diagnosis between Japanese and German hematologists. Blood and bone marrow slides of 129 patients diagnosed with FAB-RA, FAB-RA with ringed sideroblasts (RARS), or aplastic anemia were selected randomly and evaluated separately by each group. The agreements of diagnoses according to FAB and World Health Organization (WHO) classifications were 98.4% and 83.8%, respectively. Second, we compared clinical features between 131 Japanese and 597 German patients with FAB-RA. Japanese patients were significantly younger than German patients. Japanese patients had more severe cytopenias. However, prognosis of Japanese patients was significantly more favorable than that of German patients. Japanese patients had a significantly lower cumulative risk of acute leukemia evolution than did German patients. Frequency of WHO-RA in Japanese patients with FAB-RA was significantly higher than that in German patients. In conclusion, our results indicate that the clinical features of Japanese patients with FAB-RA differ from those of German patients.
Division of Hematology, Department of Internal Medicine, Saitama Medical School, 38 Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan. amatsu@saitama-med.ac.jp
Akira
A
Matsuda
Ulrich
U
Germing
Itsuro
I
Jinnai
Motohiro
M
Misumi
Andrea
A
Kuendgen
Sabine
S
Knipp
Manuel
M
Aivado
Masako
M
Iwanaga
Yasushi
Y
Miyazaki
Hideki
H
Tsushima
Mari
M
Sakai
Masami
M
Bessho
Masao
M
Tomonaga
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000753:Anemia, Refractory / Q000145:classification / Q000208:ethnology* / Q000209:etiology / Q000473:pathology*; D044466:Asian People / Q000208:ethnology; D002648:Child; D004198:Disease Susceptibility; D005260:Female; D005858:Germany / Q000208:ethnology; D006801:Humans; D007945:Leukemia, Lymphoid / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000150:complications / Q000208:ethnology* / Q000473:pathology*; D011379:Prognosis; D015996:Survival Rate