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Blood, 15 October 2005, Vol. 106, No. 8, pp. 2633-2640.
Prepublished online as a Blood First Edition Paper on June 21, 2005; DOI 10.1182/blood-2005-01-0040.
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Submitted January 6, 2005
Accepted June 12, 2005
Difference in clinical features between Japanese and German patients with refractory anemia in myelodysplastic syndromes
Akira Matsuda*, Ulrich Germing, Itsuro Jinnai, Motohiro Misumi, Andrea Kuendgen, Sabine Knipp, Manuel Aivado, Masako Iwanaga, Yasushi Miyazaki, Hideki Tsushima, Mari Sakai, Masami Bessho, and Masao Tomonaga
Division of Hematology, Department of Internal Medicine, Saitama Medical School, Moroyama, Iruma-gun, Saitama, Japan
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Dusseldolf, Germany
Department of Hematology, Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
* Corresponding author; email: amatsu{at}saitama-med.ac.jp.
Several reports indicate that there might be differences in clinical features between Asian and Western myelodysplastic syndromes (MDS) cases. We analyzed refractory anemia (RA) in French-American-British (FAB) classification cases diagnosed in Japan and Germany in order to perform a more exact comparison between Asian and Western MDS types. In the first step, we analyzed agreement of morphological 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. Secondly, we compared clinical features between 131 Japanese and 597 German FAB-RA patients. Japanese patients were significantly younger than German patients. Japanese patients had severer 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 German patients. Frequency of WHO-RA in Japanese FAB-RA patients was significantly higher than that in German patients. In conclusion, our results indicate that the clinical features of Japanese FAB-RA patients differ from those of German patients.
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