Diagnosis and Treatment of Acquired Aplastic Anaemia in Adults: 142 Cases from a Multicentre, Prospective Cohort Study in Shanghai, China

Abstract

To improve diagnosis and therapy for aplastic anaemia (AA) in Shanghai, clinical and laboratory data for patients with AA (n = 142) and hypocellular myelodysplastic syndrome (MDS; n = 22) were comparatively analysed (follow-up 2 -6 years). Red blood cell distribution width and absolute lymphocyte and reticulocyte counts were significantly different between the two groups. AA was diagnosed in 54.2% of patients using a single bone marrow aspirate smear plus peripheral haemogram results, and in 95.1% using an additional bone marrow biopsy; 4.9% required multiple-site bone marrow examination.

Outcome of match related allogeneic stem cell transplantation procedures performed from 2004 till 2011

“…Survival rates have been reported as high as 85-90%. Wang W et al has reported 74.1% [16] while Eapen M et al [17] have reported an overall survival of 76% by using bone marrow only as a source of stem cells. In our group of patients, bone marrow as well as peripheral blood was used as a combination for the source of stem cells with 71% survival which is equivalent to international literature.…”

Bone Marrow Synoptic Reporting for Hematologic Neoplasms: Guideline From the College of American Pathologists Pathology and Laboratory Quality Center

“…This recommendation is evidence-based and supported by 6 studies, [22][23][24][25][26][27] all of which met the inclusion criteria for the systematic review. These 6 studies comprise 2 prospective cohort studies (PCSs) 22,26 and 4 RCSs.…”

“…Four studies, comprising 1 PCS 22 and 3 RCSs, 24,25,27 reported clinical significance for data on platelets in MDS, myeloproliferative disease, adult T-cell leukemia/lymphoma patients. Two RCSs 24,27 reported clinical significance for data on absolute neutrophil count in patients with AA, and 1 RCS 26 reported clinical significance for data on reticulocyte count and red cell distribution width in patients with AA and MDS. Refer to Table 5 for study data by outcome of significance for peripheral blood specimens.…”

“…Peripheral blood parameters are required for the correct classification of numerous bone marrow disorders and constitute an integral component of any hematologic evaluation. There was high-level evidence demonstrating significantly different clinical outcomes for white blood cell counts in Ph þ ALL and polycythemia vera 23,25 ; hemoglobin levels in myelodysplasia and AA [26][27][28] ; platelet counts in myelodysplasia, myeloproliferative disease, adult T-cell leukemia/lymphoma 22,24,25,27 ; absolute neutrophil count in myelodysplasia 24,27 ; and red cell distribution width and reticulocyte counts in AA. 26 Other parameters, such as red blood cell morphologic descriptors, percentage of blasts, and white blood cell dysplasia, may be pertinent for diagnosis, clinical management, and documentation but showed insufficient statistical strength to inform clinical outcomes.…”

“…This recommendation is evidence-based and supported by 13 studies, 23,24,26,[29][30][31][32][33][34][35][36][37][38] all of which met the inclusion criteria for the systematic review. These 13 studies comprise 2 nonrandomized control trials (NRCTs), 32,33 4 PCS, 26,29,31,35 and 7 RCS. 23,24,30,34,[36][37][38] All studies were assessed for risk of bias, and none were found to have methodological flaws that would raise concerns about the studies' findings.…”