Comparison of severe aplastic anaemia and lower risk hypoplastic myelodysplastic neoplasms: Critical role of megakaryocyte count in distinguishing aplastic anaemia from myelodysplastic neoplasms
Although genetic abnormalities are increasingly crucial for diagnosing and classifying haematopoietic diseases, dysplasia remains crucial for distinguishing myelodysplastic neoplasms (MDS) from aplastic anaemia (AA). Erythroid dysplasia may be observed in AA, complicating the differentiation between these conditions. In a previous study using the data from the Japan Idiopathic Myelodysplastic Syndrome Study Group's registry, we found that erythroid dysplasia does not affect the prognosis of AA. This current study was designed to compare the prognosis of patients with lower risk hypoplastic MDS (LR-hMDS), as determined by our review, and patients with severe AA (SAA), all enrolled concurrently, to validate our diagnostic approach. Stringent criteria were used to rule out MDS, considering bone marrow cellularity and megakaryocyte counts, with a confirmed AA diagnosis only following a reduced megakaryocyte count. The study comprised 39 severe cases extracted from a cohort of 100 AA patients previously reported and 41 patients with LR-hMDS. Significant differences in overall and leukaemia-free survival were observed between the two groups (p < 0.0001). Even among patients undergoing immunosuppressive therapy, a marked prognostic distinction became evident after 5 years, although their response to the therapy did not differ significantly. Therefore, the megakaryocyte count is pivotal in differentiating MDS from AA.
Authors
- Kei Shimbo
- Nobuyoshi Arima (ORCID: https://orcid.org/0000-0003-0573-6685)
- Takayuki Ishikawa (ORCID: https://orcid.org/0000-0002-2098-9616)
- Hiroshi Kawabata (ORCID: https://orcid.org/0000-0002-1918-8635)
- Kensuke Usuki (ORCID: https://orcid.org/0000-0002-1216-4470)
- Akifumi Takaori‐Kondo (ORCID: https://orcid.org/0000-0001-7678-4284)
- Shinji Nakao (ORCID: https://orcid.org/0000-0002-9674-624X)
- Shunya Arai (ORCID: https://orcid.org/0000-0003-0445-7991)
- Tomoya Maeda (ORCID: https://orcid.org/0000-0002-3107-5991)
- Kinuko Mitani (ORCID: https://orcid.org/0000-0001-9736-9469)
- Maki Shindo‐Ueda
- Kaoru Tohyama (ORCID: https://orcid.org/0000-0002-0812-9816)
- Akira Matsuda (ORCID: https://orcid.org/0000-0002-0792-3663)
- Takahiro Suzuki (ORCID: https://orcid.org/0000-0002-8438-2186)
- Shigeru Chiba (ORCID: https://orcid.org/0000-0001-7803-7338)
- Yasushi Miyazaki (ORCID: https://orcid.org/0000-0003-3683-7147)
- Junya Kanda (ORCID: https://orcid.org/0000-0002-6704-3633)
- Kayano Araseki
- Hidekazu Kayano (ORCID: https://orcid.org/0000-0001-9349-4959)
- Masaharu Nohgawa
- Mineo Kurokawa (ORCID: https://orcid.org/0000-0002-4034-2422)
- Akira Kitanaka (ORCID: https://orcid.org/0000-0002-2659-8405)
- Akiko Ohta
- Tomoko Hata (ORCID: https://orcid.org/0000-0002-9115-1749)
- Keiya Ozawa
Institutions
- Kanazawa University (JP)
- University of Tsukuba (JP)
- Jichi Medical University (JP)
- Kawasaki Medical School (JP)
- Kyoto University (JP)
- Kyoto Medical Center (JP)
- Mito Saiseikai General Hospital (JP)
- Nagasaki Medical Center (JP)
- Shinko Hospital (JP)
- Japanese Red Cross Kanazawa Hospital (JP)
- Japanese Red Cross Society Wakayama Medical Center (JP)
- Tokyo Metropolitan Police Hospital (JP)
- Kobe City Medical Center General Hospital (JP)
- Nagasaki University (JP)
- Kawasaki University of Medical Welfare (JP)
- Kitasato University (JP)
- The University of Tokyo (JP)
- Dokkyo Medical University (JP)
- Saitama Medical University (JP)
- Teikyo University (JP)
Publication Details
- Journal
- British Journal of Haematology
- Published
- 2025-04-22
- DOI
- https://doi.org/10.1111/bjh.20097
- Primary Topic
- Acute Myeloid Leukemia Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Ministry of Health, Labour and Welfare