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Natural history of moderate aplastic anemia in children
Author(s) -
Howard Scott C.,
Naidu Paula E.,
Hu X. Joan,
Jeng Michael R.,
RodriguezGalindo Carlos,
Rieman Martha D.,
Wang Winfred C.
Publication year - 2004
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20131
Subject(s) - medicine , aplastic anemia , bone marrow failure , bone marrow , anemia , pediatrics , absolute neutrophil count , bone marrow examination , gastroenterology , neutropenia , chemotherapy , haematopoiesis , stem cell , biology , genetics
Abstract Background Moderate aplastic anemia (MAA) in children is a rare, idiopathic condition of bone marrow insufficiency that can resolve spontaneously, persist for months or years, or progress to severe aplastic anemia (SAA). We evaluated the rate of progression to SAA. Methods We reviewed the records of 136 children referred for evaluation of bone marrow failure from 1978 to 2002 at St. Jude Children's Research Hospital. MAA was defined by a hypocellular bone marrow (<50%) and 2 or 3 cytopenias (absolute neutrophil count <1,500/mm 3 , absolute reticulocyte count <40,000/mm 3 , platelet count <100,000/mm 3 ) lasting at least 6 weeks. Results Twenty‐four patients met the criteria for MAA. At a median follow‐up of 66 months (range, 10–293), 16 patients (67%) progressed to SAA, 5 (21%) had persistent MAA, and 3 (12%) had complete resolution of MAA. No risk factors for progression could be identified. Conclusions When childhood MAA is treated with supportive care alone, 2/3 of patients progress to SAA. © 2004 Wiley‐Liss, Inc.