Treatment responses of childhood aplastic anaemia with chromosomal aberrations at diagnosis

Shoichi Ohga, Akira Ohara, Shigeyoshi Hibi, Seiji Kojima, Fumio Bessho, Shigeru Tsuchiya, Yukio Ohshima, Nobuyuki Yoshida, Yoshifumi Kashii, Shinichiro Nishimura, Kiyoshi Kawakami, Kenichi Nishikawa, Ichiro Tsukimoto

Research output: Contribution to journalArticle

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Abstract

The clinical outcome of childhood aplastic anaemia (AA) with aberrant cytogenetic clones at diagnosis was surveyed. Among 198 children with newly diagnosed AA registered with the AA Committee of the Japanese Society of Paediatric Hematology between 1994 and 1998, cytogenetic studies of bone marrow (BM) cells were completed in 159 patients. Apart from one Robertsonian translocation, seven patients (4.4%) showed clonal chromosomal abnormalities in hypoplastic BM without myelodysplastic features. The patients included six girls and one boy with a median age of 11 years (range 5-14 years). Six patients had del(6), del(5), del(13), del(20), or -7, and one showed add(9). Four patients responded to the first immunosuppressive therapy (IST: cyclosporin A plus antithymocyte globulin) and one obtained a spontaneous remission. Cytogenetic abnormalities remained in two patients with an IST response. On the other hand, two patients showed no IST response. One did not respond to repeat IST and died of acute graft-versus-host disease after an unrelated-BM transplant. Another obtained a complete response after a successful BM transplant. No haematological findings at diagnosis predicted the treatment response. No significant morphological changes developed during the course of the illness. A literature review revealed that half of 24 AA patients with chromosomal abnormalities responded to the first IST, and that +6 was the sole predictable marker for IST unresponsiveness. These results suggest that IST can be applied as the initial therapy for AA with cytogenetic abnormalities in the absence of completely matched donors.

Original languageEnglish
Pages (from-to)313-319
Number of pages7
JournalBritish Journal of Haematology
Volume118
Issue number1
DOIs
Publication statusPublished - Jul 27 2002

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Aplastic Anemia
Chromosome Aberrations
Bone Marrow
Therapeutics
Cytogenetics
Spontaneous Remission
Transplants
Antilymphocyte Serum
Graft vs Host Disease
Hematology
Immunosuppressive Agents
Bone Marrow Cells
Cyclosporine
Clone Cells
Tissue Donors
Pediatrics

All Science Journal Classification (ASJC) codes

  • Hematology

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Treatment responses of childhood aplastic anaemia with chromosomal aberrations at diagnosis. / Ohga, Shoichi; Ohara, Akira; Hibi, Shigeyoshi; Kojima, Seiji; Bessho, Fumio; Tsuchiya, Shigeru; Ohshima, Yukio; Yoshida, Nobuyuki; Kashii, Yoshifumi; Nishimura, Shinichiro; Kawakami, Kiyoshi; Nishikawa, Kenichi; Tsukimoto, Ichiro.

In: British Journal of Haematology, Vol. 118, No. 1, 27.07.2002, p. 313-319.

Research output: Contribution to journalArticle

Ohga, S, Ohara, A, Hibi, S, Kojima, S, Bessho, F, Tsuchiya, S, Ohshima, Y, Yoshida, N, Kashii, Y, Nishimura, S, Kawakami, K, Nishikawa, K & Tsukimoto, I 2002, 'Treatment responses of childhood aplastic anaemia with chromosomal aberrations at diagnosis', British Journal of Haematology, vol. 118, no. 1, pp. 313-319. https://doi.org/10.1046/j.1365-2141.2002.03582.x
Ohga, Shoichi ; Ohara, Akira ; Hibi, Shigeyoshi ; Kojima, Seiji ; Bessho, Fumio ; Tsuchiya, Shigeru ; Ohshima, Yukio ; Yoshida, Nobuyuki ; Kashii, Yoshifumi ; Nishimura, Shinichiro ; Kawakami, Kiyoshi ; Nishikawa, Kenichi ; Tsukimoto, Ichiro. / Treatment responses of childhood aplastic anaemia with chromosomal aberrations at diagnosis. In: British Journal of Haematology. 2002 ; Vol. 118, No. 1. pp. 313-319.
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