BACKGROUND: Cytogenetic abnormalities (CAs) have been reported frequently in patients with otherwise typical aplastic anemia (AA), but their implications in the prognosis and in the evolution to hematologic malignancies are controversial. METHODS: We retrospectively analyzed 127 adult AA patients who had successful cytogenetic analysis at initial diagnosis. RESULTS: The patients were classified into 3 groups according to the initial and follow-up results of cytogenetic profiles. Group 1 included patients who had persistent AA with normal cytogenetic profiles (N=117); Group 2, those who had a normal cytogenetic profile at initial diagnosis but later acquired CA (N=4, 3.1%); and Group 3, those who had CA at the initial diagnosis, regardless of follow-up cytogenetic status (N=6,4.7%). In Group 2, 2 patients later developed CA without progression to acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS); the other 2 patients later progressed to AML. None of the patients in Group 3 progressed to AML or MDS. There was no significant difference in overall survival between Groups 1 and 3. CONCLUSION: AA patients with CA at initial diagnosis or follow-up may not be at greater risk for evolution to AML or MDS, or show shorter survival periods. Prospective studies and a larger patient samples are needed to establish the clinical relevance of CA.
BACKGROUND: Cytogenetic abnormalities (CAs) have been reported frequently in patients with otherwise typical aplastic anemia (AA), but their implications in the prognosis and in the evolution to hematologic malignancies are controversial. METHODS: We retrospectively analyzed 127 adult AA patients who had successful cytogenetic analysis at initial diagnosis. RESULTS: The patients were classified into 3 groups according to the initial and follow-up results of cytogenetic profiles. Group 1 included patients who had persistent AA with normal cytogenetic profiles (N=117); Group 2, those who had a normal cytogenetic profile at initial diagnosis but later acquired CA (N=4, 3.1%); and Group 3, those who had CA at the initial diagnosis, regardless of follow-up cytogenetic status (N=6,4.7%). In Group 2, 2 patients later developed CA without progression to acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS); the other 2 patients later progressed to AML. None of the patients in Group 3 progressed to AML or MDS. There was no significant difference in overall survival between Groups 1 and 3. CONCLUSION: AA patients with CA at initial diagnosis or follow-up may not be at greater risk for evolution to AML or MDS, or show shorter survival periods. Prospective studies and a larger patient samples are needed to establish the clinical relevance of CA.
Authors: Judith C W Marsh; Sarah E Ball; Jamie Cavenagh; Phil Darbyshire; Inderjeet Dokal; Edward C Gordon-Smith; Jane Keidan; Andrew Laurie; Anna Martin; Jane Mercieca; Sally B Killick; Rhona Stewart; John A L Yin Journal: Br J Haematol Date: 2009-08-10 Impact factor: 6.998
Authors: Vikas Gupta; Carol Brooker; Jennifer A Tooze; Qi-Long Yi; Deborah Sage; David Turner; Pamela Kangasabapathy; Judith C W Marsh Journal: Br J Haematol Date: 2006-07 Impact factor: 6.998
Authors: Jeffrey J Molldrem; Eric Leifer; Erkut Bahceci; Yogen Saunthararajah; Mary Rivera; Cynthia Dunbar; Johnson Liu; Riotoro Nakamura; Neal S Young; A John Barrett Journal: Ann Intern Med Date: 2002-08-06 Impact factor: 25.391
Authors: K Paulsson; M Heidenblad; B Strömbeck; J Staaf; G Jönsson; A Borg; T Fioretos; B Johansson Journal: Leukemia Date: 2006-05 Impact factor: 11.528