Comparison of long-term outcomes between children with aplastic anemia and refractory cytopenia of childhood who received immunosuppressive therapy with antithymocyte globulin and cyclosporine
Asahito Hama,
Yoshiyuki Takahashi,
Hideki Muramatsu,
Masafumi Ito,
Atsushi Narita,
Yoshiyuki Kosaka,
Masahiro Tsuchida,
Ryoji Kobayashi,
Etsuro Ito,
Hiromasa Yabe,
Shouichi Ohga,
Akira Ohara,
Seiji Kojima
Affiliations
Asahito Hama
Department of Pediatrics, Nagoya University Graduate School of Medicine, Kobe, Japan
Yoshiyuki Takahashi
Department of Pediatrics, Nagoya University Graduate School of Medicine, Kobe, Japan
Hideki Muramatsu
Department of Pediatrics, Nagoya University Graduate School of Medicine, Kobe, Japan
Masafumi Ito
Department of Pathology, Japanese Red Cross Nagoya First Hospital, Kobe, Japan
Atsushi Narita
Department of Pediatrics, Nagoya University Graduate School of Medicine, Kobe, Japan
Yoshiyuki Kosaka
Department of Pediatrics, Hyogo Children’s Hospital, Kobe, Japan
Masahiro Tsuchida
Department of Pediatrics, Ibaraki Children’s Hospital, Isehara, Japan
Ryoji Kobayashi
Department of Pediatrics, Sapporo Hokuyu Hospital, Isehara, Japan
Etsuro Ito
Department of Pediatrics, Hirosaki University Graduate School of Medicine, Isehara, Japan
Hiromasa Yabe
Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan
Shouichi Ohga
Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Tokyo, Japan
Akira Ohara
Department of Transfusion Medicine, Toho University School of Medicine, Tokyo, Japan
Seiji Kojima
Department of Pediatrics, Nagoya University Graduate School of Medicine, Kobe, Japan
The 2008 World Health Organization classification proposed a new entity in childhood myelodysplastic syndrome, refractory cytopenia of childhood. However, it is unclear whether this morphological classification reflects clinical outcomes. We retrospectively reviewed bone marrow morphology in 186 children (median age 8 years; range 1–16 years) who were enrolled in the prospective study and received horse antithymocyte globulin and cyclosporine between July 1999 and November 2008. The median follow-up period was 87 months (range 1–146 months). Out of 186 patients, 62 (33%) were classified with aplastic anemia, 94 (49%) with refractory cytopenia of childhood, and 34 (18%) with refractory cytopenia with multilineage dysplasia. Aplastic anemia patients received granulocyte colony-stimulating factor more frequently and for longer durations than other patients (P
