title: [Bone marrow findings of childhood aplastic anemia: analyses of 140 cases by central reviewers].
abstract: The revised WHO classification proposed the term "refractory cytopenia of childhood (RCC)" for children with myelodysplastic syndrome (MDS) with a low blast count. The differential diagnosis between RCC and aplastic anemia (AA) is challenging, especially when bone marrow is hypoplastic and there is no detectable chromosomal abnormality. To reveal the difference between AA and RCC with respect to the clinical and biological features, we retrospectively reviewed the bone marrow smears of 140 patients registered for childhood AA-97 study, which were classified into three groups as follows; the AA group was defined as having no morphologically dysplastic changes; the AA-RCC borderline group was defined as having <10% dysplastic changes in the erythroid lineage only; and the RCC group was defined as having dysplastic changes in more than two cell lineages or >10% in a single cell lineage. The patients were classified into the AA group (n=96, 69%), AA-RCC borderline group (n=20, 14%) and RCC group (n=24, 17%). Most of the patients in the AA group were classified as having very severe disease, whereas most of the patients in the RCC group were classified as non-severe disease. Only 2 patients in the AA group developed acute myeloid leukemia. The response rate to immunosuppressive therapy did not differ among the 3 groups. To demonstrate whether the two diseases are truly different entities, it is necessary to compare molecular backgrounds between the AA and RCC groups.
authors: Department of Pediatrics, Nagoya University Graduate School of Medicine.
authors: Asahito
authors: A
authors: Hama
authors: Ayami
authors: A
authors: Yoshimi
authors: Hirotoshi
authors: H
authors: Sakaguchi
authors: Sayoko
authors: S
authors: Doisaki
authors: Hideki
authors: H
authors: Muramatsu
authors: Akira
authors: A
authors: Shimada
authors: Yoshiyuki
authors: Y
authors: Takahashi
authors: Kazue
authors: K
authors: Nozawa
authors: Masafumi
authors: M
authors: Ito
authors: Masahiro
authors: M
authors: Tsuchida
authors: Atsushi
authors: A
authors: Manabe
authors: Akira
authors: A
authors: Ohara
authors: Seiji
authors: S
authors: Kojima
mesh_terms: D000293:Adolescent; D000741:Anemia, Aplastic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents