Abstract |
Prognostic refinement in Fanconi anemia (FA) is needed, especially when considering allogeneic hematopoietic stem cell transplantation (HCT). We studied 20 children with FA and bone marrow failure from a single center. According to Hôpital Saint-Louis risk classification for FA, patients were classified in stage A (no or mild cytopenia/dysplasia), B (single non-high-risk cytogenetic abnormality), C (severe cytopenia and/or significant dysplasia and/or high-risk cytogenetic abnormality), and D ( myelodysplastic syndrome with excess of blasts/ acute myeloid leukemia) in 4, 2, 13, and 0 cases, respectively. Nine patients received androgens +/- steroids, with a response rate of 30%, and 11 patients underwent HCT. Ten-year cumulative incidence (CI) of myelodysplastic syndrome/acute myeloid leukemia and overall survival (OS) were 21.9% and 45.3%, respectively, in the entire cohort, whereas cumulative incidence of transplantation-related mortality and OS were 27% and 63%, respectively, in patients who underwent HCT. Patients with significant dysplasia at diagnosis (stages C and D) had significantly shorter OS post-HCT as compared with patients without dysplasia. All patients in stages C and D at diagnosis or during evolution died from their disease. HCT in recent years was associated with more favorable outcomes. Larger cohorts could validate homogenous reporting of risk and help decision-making, particularly for HCT.
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Authors | Charikleia Kelaidi, Alexandros Makis, Loizos Petrikkos, Kondilia Antoniadi, Nikoletta Selenti, Vasiliki Tzotzola, Eleni-Dikaia Ioannidou, Konstantinos Tsitsikas, Vassiliki Kitra, Ariadni Kalpini-Mavrou, Helen Fryssira, Sophia Polychronopoulou |
Journal | Journal of pediatric hematology/oncology
(J Pediatr Hematol Oncol)
Vol. 41
Issue 8
Pg. 612-617
(11 2019)
ISSN: 1536-3678 [Electronic] United States |
PMID | 31259830
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adolescent
- Androgens
(administration & dosage)
- Child
- Child, Preschool
- Disease-Free Survival
- Fanconi Anemia
(diagnosis, drug therapy, genetics, mortality)
- Female
- Humans
- Infant
- Leukemia, Myeloid, Acute
(diagnosis, drug therapy, genetics, mortality)
- Male
- Myelodysplastic Syndromes
(diagnosis, drug therapy, genetics, mortality)
- Retrospective Studies
- Risk Assessment
- Survival Rate
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