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Stable long‐term risk of leukaemia in patients with severe congenital neutropenia maintained on G‐CSF therapy
Authors:Philip S. Rosenberg  Cornelia Zeidler  Audrey A. Bolyard  Blanche P. Alter  Mary A. Bonilla  Laurence A. Boxer  Yigal Dror  Sally Kinsey  Daniel C. Link  Peter E. Newburger  Akiko Shimamura  Karl Welte  David C. Dale
Affiliation:1. Biostatistics Branch, National Cancer Institute, Rockville, MD, USA;2. These authors contributed equally.;3. Kinderklinik, Medizinische Hochschule, Carl‐Neuberg‐Str. 1, Hannover, Germany;4. Department of Medicine, University of Washington, Seattle, WA;5. Clinical Genetics Branch, National Cancer Institute, Rockville, MD;6. St. Joseph’s Children’s Hospital, Pediatric Hematology Oncology, Paterson NJ;7. University of Michigan, Pediatric Hematology/Oncology, Ann Arbor, MI, USA;8. Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada;9. Paediatric Haematology, St. James’s University Hospital, Leeds, UK;10. Washington University School of Medicine, Division of Bone Marrow Transplantation, St. Louis, MO;11. University of Massachusetts Medical School, Worcester, MA;12. Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Abstract:In severe congenital neutropenia (SCN), long‐term therapy with granulocyte colony‐stimulating factor (G‐CSF) has reduced mortality from sepsis, revealing an underlying predisposition to myelodysplastic syndrome and acute myeloid leukaemia (MDS/AML). We have reported the early pattern of evolution to MDS/AML, but the long‐term risk remains uncertain. We updated a prospective study of 374 SCN patients on long‐term G‐CSF enrolled in the Severe Chronic Neutropenia International Registry. Long‐term, the annual risk of MDS/AML attained a plateau (2·3%/year after 10 years). This risk now appears similar to, rather than higher than, the risk of AML in Fanconi anaemia and dyskeratosis congenita.
Keywords:severe congenital neutropenia  acute myeloid leukaemia  myelodysplastic syndromes  granulocyte colony‐stimulating factor
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