The Incidence,
Diagnosis and Treatment of Myelodysplastic Syndrome in Children in the Czech Republic:
Results of the Prospective Study of the EWOG-MDS 1998–2002
Starý J.1, Housková J.2, Michalová K.3, Zemanová Z.3, Zámková A.2, Ptoszková H.4, .....
1II. dětská klinika UK 2. LF a FN Motol, Praha, 2Oddělení klinické hematologie, FN Motol, Praha, 3Centrum nádorové cytogenetiky UK 1. LF a VFN, Praha, 4Dětská klinika FNsP, Ostrava, .... |
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Summary:
The Czech Working Group for Paediatric Haematology participated in the international prospective
study for the diagnosis and therapy of myelodysplastic syndrome (MDS) in childhood organized by the
European Working Group for Myelodysplastic Syndrome (EWOG-MDS) in 1998–2002. The aim of the
study was to improve the accuracy of diagnosis in children and adolescents withMDS by a standardized
review of morphology and standardized cytogenetic and molecular analyses. The secondary objective
of the study was to improve survival of children with primary MDS over that reported in the literature.
During the study period (1998–2002), twenty-one children were diagnosed with MDS in the Czech
Republic – 16 with primary MDS and juvenile myelomonocytic leukaemia (JMML); 3 with myeloid
leukaemia and Down’s syndrome; and 2 with secondary MDS. MDS accounted for 5.5–8 % of the
haematologicmalignancies.Of the 16 childrenwith primaryMDS 5 suffered from refractory cytopenia,
7 from RAEB/RAEBt, and 4 from JMML. The most common cytogenetic abnormality was monosomy 7
in 33 % of the patients. Two boys with primary MDS had a predisposing condition – neurofibromatosis
type 1. Thirteen children underwent stem cell transplantation, 4 were treated by intensive AML-type
chemotherapy, and 4 patients were followed up without treatment. Eleven children (52 %) are alive and
well.
Key words:
MDS, children, epidemiology, morphology, cytogenetics, stem cell transplantation
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