New perspectives on the differentiation of aplastic anemia and MDS in children

Due to recent advances in immunosuppressive therapy, the prognosis for apla stic anemia (AA) has improved dramatically. As more patients with this dise ase have been surviving longer, the number of AA patients who develop myelo dysplastic syndrome (MDS) or leukemia has increased. However, it is unclear whether the development of this type of late clonal disorder is related to a particular therapy, and whether hypoplastic MDS can be differentiated fr om AA at diagnosis. Although there are no definitive answers to these quest ions, some forms of AA and MDS are likely within the same spectrum of disea se. Thus, when treating AA, it is essential to evaluate various clinical an d laboratory information, including cell morphology and chromosomal aberrat ion. This paper discusses acute myelocytic leukemia (AML) and MDS in childr en diagnosed as having AA, and it presents problems associated with the dia gnosis of this disease.