Analysis of Ten Childhood Cases Which Correspond to the Criteria of Ill-Defined Dyshematopoiesis

Abstract

Since the myelodysplastic syndrome (MDS) usually occurs with elderly patients, there have been few reports describing the syndrome during the childhood period. But recently, pediatric hematologists clearly recognize that MDS is less rare than was previously thought. Childhood MDS is diagnosed on the classification of the French-America-British Cooperative Study Group (FAB) but we still have such cases with hematopoietic dysplasia which are difficult to classify by the FAB system. The classification of ill-defined dyshematopoiesis has not been widely accepted yet but is considered to be very useful to observe and treat patients with unexplainable cytopenias. We reported ten childhood cases that correspond to the criteria of ill-defined dyshematopoiesis and analyzed their hematological features. Six patients out of ten developed leukemia after four months to nine years. Elevated serum levels of LDH (above 400 IU/l) and especially elevated LDH II ratio at the onset may be a factor for predicting leukemia development. More data regarding the MDS and ill-defined dyshematopoiesis in children is obviously needed.