Clinical Analysis Of 20 Cases Of Pediatric Refractory Anemia With Excess Of Blasts

ObjectiveAnalyze the clinical data of the children with RAEB.MethodsTwenty pediatric RAEB were reclassified according to the criterion of 2015 edition the Chinese expert consensus for the diagnosis and treatment of childhood myelodysplastic syndrome.Twenty childhood diagnosed as RAEB in the department of Pediatric Hematology Oncology,the Fist Affiliated Hospital of Zhengzhou University between January 2010 and October 2017 were enrolled in the study.Clinical features,laboratory features,diagnosis,treatment,outcome dates and prognosis were retrospectively studied.Results13 males and 7 females were identified.Clinical symptoms were anemia(18cases,90%),fever(14cases,70%),hepatosplenomegaly(12 cases,60%),lymph node enlargement(5cases,25%),bleeding(6cases,30%),other symptoms(4cases,20%).Laboratory examinations : bone marrow proliferation was active(18cases,90%).Dysplasia was main features in bone marrow,two lineages and three lineages of hematopoietic dysplasia(17cases,85%).Abnormal chromosome were 3cases(15%).Treatment and outcomes:hematopoietic stem cell transplantation(HSCT)5 cases,chemotherapy 7cases,abandoned treatment 8 cases,converting into acute myeloid leukemia 6 cases(time range 1~26 months),died 12 cases(60%).Conclusion1.The male has higher incidence ratio during pediatric RAEB.2.The age can be a risk factor of scute onset for RAEB.3.Thrombocytopenia could be a risk factor of scute onset for pediatric RAEB,but the conclusion should be validated by more researches.4.The excess blasts could be a risk factor of scute onset for RAEB.5.FCM maybe an examination of abnormal blasts.6.Pediatric RAEB are characterized by a high death rate and a high rate of conversion to leukemia.Hematopeietic stem cell transplantation is the only treatment option with a realistic curative potential for pediatric RAEB.