SEARCH:   Advanced

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kojima, S. Articles by Tsukimoto, I. Search for Related Content PubMed PubMed Citation Articles by Kojima, S. Articles by Tsukimoto, I. Related Collections Neoplasia Clinical Trials and Observations 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: R. Gurion, A. Gafter-Gvili, M. Paul, L. Vidal, I. Ben-Bassat, M. Yeshurun, O. Shpilberg, and P. Raanani Hematopoietic growth factors in aplastic anemia patients treated with immunosuppressive therapy-systematic review and meta-analysis Haematologica, May 1, 2009; 94(5): 712 - 719. [Abstract] [Full Text] [PDF] J. R. Passweg and A. Tichelli Immunosuppressive treatment for aplastic anemia: are we hitting the ceiling? Haematologica, March 1, 2009; 94(3): 310 - 312. [Full Text] [PDF] 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. Sykora, T. Klingebiel, U. Gross-Wieltsch, M. M van den Heuvel-Eibrink, A. Fischer, et al. Immunosuppressive therapy with anti-thymocyte globulin and cyclosporine A in selected children with hypoplastic refractory cytopenia Haematologica, March 1, 2007; 92(3): 397 - 400. [Abstract] [Full Text] [PDF] J. C.W. Marsh Treatment of acquired aplastic anemia Haematologica, January 1, 2007; 92(1): 2 - 5. [Full Text] [PDF] N. S. Young, R. T. Calado, and P. Scheinberg Current concepts in the pathophysiology and treatment of aplastic anemia Blood, October 15, 2006; 108(8): 2509 - 2519. [Abstract] [Full Text] [PDF] E. M. Sloand, A. S. M. Yong, S. Ramkissoon, E. Solomou, T. C. Bruno, S. Kim, M. Fuhrer, S. Kajigaya, A. J. Barrett, and N. S. Young Granulocyte colony-stimulating factor preferentially stimulates proliferation of monosomy 7 cells bearing the isoform IV receptor PNAS, September 26, 2006; 103(39): 14483 - 14488. [Abstract] [Full Text] [PDF] N. S. Young Pathophysiologic Mechanisms in Acquired Aplastic Anemia Hematology, January 1, 2006; 2006(1): 72 - 77. [Abstract] [Full Text] [PDF] D. P. Steensma and J. M. Bennett The Myelodysplastic Syndromes: Diagnosis and Treatment Mayo Clin. Proc., January 1, 2006; 81(1): 104 - 130. [Abstract] [Full Text] [PDF] M. Fuhrer, U. Rampf, I. Baumann, A. Faldum, C. Niemeyer, G. Janka-Schaub, W. Friedrich, W. Ebell, A. Borkhardt, C. Bender-Goetze, et al. Immunosuppressive therapy for aplastic anemia in children: a more severe disease predicts better survival Blood, September 15, 2005; 106(6): 2102 - 2104. [Abstract] [Full Text] [PDF] K. Kuramoto, D. A. Follmann, P. Hematti, S. Sellers, B. A. Agricola, M. E. Metzger, R. E. Donahue, C. von Kalle, and C. E. Dunbar Effect of chronic cytokine therapy on clonal dynamics in nonhuman primates Blood, June 1, 2004; 103(11): 4070 - 4077. [Abstract] [Full Text] [PDF]

	Copyright © 2002 by American Society of Hematology         Online ISSN: 1528-0020