Premium
A Cytokine‐Based Diagnostic Program in Pediatric Aplastic Anemia and Hypocellular Refractory Cytopenia of Childhood
Author(s) -
Elmahdi Shaimaa,
Hama Asahito,
Manabe Atsushi,
Hasegawa Daisuke,
Muramatsu Hideki,
Narita Atsushi,
Nishio Nobuhiru,
Ismael Olfat,
Kawashima Nozomu,
Okuno Yusuke,
Xu Yinyan,
Wang Xinan,
Takahashi Yoshiyuki,
Ito Masafumi,
Kojima Seiji
Publication year - 2016
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.25799
Subject(s) - medicine , cytopenia , aplastic anemia , refractory (planetary science) , refractory anemia , pediatrics , myelodysplastic syndromes , immunology , bone marrow , physics , astrobiology
Background Distinguishing hypocellular refractory cytopenia of childhood (RCC) from aplastic anemia (AA) is challenging. Thus far, no studies have compared the cytokine profiles in patients with AA to those with hypocellular RCC. In the present study, we addressed whether thrombopoietin (TPO) and interleukin 17 (IL‐17) plasma levels are useful for differentiating between the two diseases. Methods We measured the endogenous plasma concentrations of TPO and IL‐17 in 29 patients with AA, 34 patients with hypocellular RCC, and 31 healthy controls using sensitive enzyme‐linked immunosorbent assays. Results The TPO and IL‐17 plasma levels were significantly lower in patients with hypocellular RCC than in patients with AA ( P < 0.001 and P = 0.007, respectively). The multivariate logistic regression analysis identified moderate disease severity, TPO levels of <1,369.8 pg/ml (TPO‐low group, n = 32; odds ratio (OR), 13.40; 95% confidence intervals (CI), 3.001–51.254; P < 0.001), and IL‐17 levels of <22.2 pg/ml (IL‐17‐low group, n = 33; OR, 4.11; 95% CI, 1.033—19.404; P = 0.031) as independent factors discriminating hypocellular RCC from AA. Importantly, 25 (78.1%) of 32 patients in the TPO‐low group and 25 (75.8%) of 33 patients in the IL‐17‐low group were diagnosed as having hypocellular RCC. Moreover, 22 (71%) of 31 patients in the TPO‐high group and 21 (70%) of 30 patients in the IL‐17‐high group were diagnosed as having AA. Conclusions TPO and IL‐17 levels are useful for differentiating hypocellular RCC from AA. Prospective studies are required to confirm our findings.