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Related Collections Clinical Trials and Observations Neoplasia Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 August 2002, Vol. 100, No. 3, pp. 786-790 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Risk factors for evolution of acquired aplastic anemia into myelodysplastic syndrome and acute myeloid leukemia after immunosuppressive therapy in children Seiji Kojima, Akira Ohara, Masahiro Tsuchida, Toru Kudoh, Ryoji Hanada, Yuri Okimoto, Takashi Kaneko, Toshikuni Takano, Koichiro Ikuta, and Ichiro Tsukimoto for the Japan Childhood Aplastic Anemia Study Group From the multicenter collaborative study group, Japan Childhood Aplastic Anemia Study Group. 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. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Teramura, A. Kimura, S. Iwase, Y. Yonemura, S. Nakao, A. Urabe, M. Omine, and H. Mizoguchi Treatment of severe aplastic anemia with antithymocyte globulin and cyclosporin A with or without G-CSF in adults: a multicenter randomized study in Japan Blood, September 15, 2007; 110(6): 1756 - 1761. [Abstract] [Full Text] [PDF] B. P. Alter and P. S. Rosenberg Granulocyte colony-stimulating factor and severe aplastic anemia Blood, May 15, 2007; 109(10): 4589 - 4589. [Full Text] [PDF] A. Yoshimi, I. Baumann, M. Fuhrer, E. Bergstrasser, U. Gobel, K.-W. 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