Clinical features of childhood refractory cytopenia / 中国当代儿科杂志
Chinese Journal of Contemporary Pediatrics
; (12): 15-21, 2015.
Article
in Zh
| WPRIM
| ID: wpr-289478
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To study the clinical features of patients with refractory cytopenia of childhood (RCC).</p><p><b>METHODS</b>The clinical data of 1 420 children (0-14 years old) with an initial diagnosis of non-severe aplastic anemia between January 1990 and June 2013 were retrospectively analyzed. Bone marrow cell morphology and histopathology were re-evaluated, and the patients were re-classified using the criteria proposed in the 2008 edition of the World Health Organization classification of RCC in hematopoietic and lymphoid tumor tissues. The clinical outcomes were followed up every 3-6 months.</p><p><b>RESULTS</b>Among all the 1 420 cases, 152 (10.7%) were reassessed as RCC. Patients with RCC had a lower level of hemoglobin and a higher percentage of fetal hemoglobin than those with non-severe aplastic anemia. Of the patients with RCC, 21.5% showed abnormal karyotypes at diagnosis. The median follow-up period for all patients was 36 months (ranging from 1 to 283 months). The rates of complete response, partial response, and no response to cyclosporine and androgen treatment in RCC patients were 19.0%, 26.7%, and 54.3%, respectively. The 5- and 10-year prospective overall survival rates of RCC patients were 87.9% and 72.4%, respectively. The 5- and 10-year prospective clonal evolution rates were 15.3% and 20.0%, respectively. The 2-year prospective incidence of newly diagnosed karyotype abnormality after the initial diagnosis was 3.6%. The 5- and 10-year prospective leukemia transformation rates were 10.0% and 20.0%, respectively.</p><p><b>CONCLUSIONS</b>RCC shows clinical features similar to adult myelodysplastic syndrome. Children with RCC have a poor prognosis, an increased risk of transformation to leukemia, and a low response rate to cyclosporine treatment.</p>
Full text:
1
Index:
WPRIM
Main subject:
Pancytopenia
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Prognosis
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Myelodysplastic Syndromes
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Retrospective Studies
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Mortality
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Drug Therapy
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Clonal Evolution
Type of study:
Observational_studies
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Prognostic_studies
Limits:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
Language:
Zh
Journal:
Chinese Journal of Contemporary Pediatrics
Year:
2015
Type:
Article