Korean J Hematol.  2010 Dec;45(4):242-246. 10.5045/kjh.2010.45.4.242.

Incidence and clinical characteristics of clonal cytogenetic abnormalities of acquired aplastic anemia in adults

Affiliations
  • 1Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea. kimhj@dau.ac.kr
  • 2Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.
  • 3Department of Hemato-Oncology, Pusan National University Hospital, Busan, Korea.
  • 4Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
  • 5Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Abstract

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.

Keyword

Aplastic anemia; Cytogenetic abnormality

MeSH Terms

Adult
Anemia, Aplastic
Chromosome Aberrations
Cytogenetic Analysis
Cytogenetics
Follow-Up Studies
Hematologic Neoplasms
Humans
Incidence
Leukemia, Myeloid, Acute
Myelodysplastic Syndromes
Prognosis
Retrospective Studies

Figure

  • Fig. 1 Survival curves according to the severity of patients. The median survival was 103.3 months in SAA vs. not yet reached in NSAA (P=0.0014).


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