Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan.
Division of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan.
Pediatr Int. 2020 Aug;62(8):907-910. doi: 10.1111/ped.14214. Epub 2020 Jul 9.
Abnormal blood cell counts are characteristic of patients with Down syndrome and transient abnormal myelopoiesis (TAM). Although some patients with TAM experience prolonged anemia or thrombocytopenia, hematological factors predicting blood cell count recovery have not been reported yet. The aim of this study was to investigate the factors influencing platelet normalization in TAM.
A retrospective review of the medical records of 21 patients with TAM admitted to the neonatal intensive care unit at Kanagawa Children's Medical Center between January 2007 and October 2014 was undertaken.
In the 16 of 21 patients (76%) experiencing transient thrombocytopenia, a large number of blasts at diagnosis was found to be significantly associated with late platelet recovery (R = 0.669, P < 0.05), and higher platelet counts at diagnosis were significantly associated with later recovery (R = 0.719, P < 0.01). Indeed, a strong positive correlation between blast and platelet counts at diagnosis was found (R = 0.730, P < 0.01).
Our data suggest that high platelet counts at TAM diagnosis might reflect abnormal thrombocyte production from blasts. Thus, physicians should be aware of the possibility of prolonged thrombocytopenia in patients with TAM who exhibit a high platelet and/or blast count at diagnosis.
唐氏综合征患者和短暂性髓系增生异常（TAM）的特征是血细胞计数异常。尽管一些 TAM 患者经历持续的贫血或血小板减少，但尚未报道预测血细胞计数恢复的血液学因素。本研究旨在探讨影响 TAM 血小板正常化的因素。
回顾性分析 2007 年 1 月至 2014 年 10 月期间在神奈川儿童医疗中心新生儿重症监护病房收治的 21 例 TAM 患者的病历。
在 21 例（76%）经历短暂性血小板减少症的患者中，诊断时大量原始细胞与血小板恢复延迟显著相关（R = 0.669，P < 0.05），诊断时较高的血小板计数与较晚的恢复显著相关（R = 0.719，P < 0.01）。实际上，诊断时原始细胞和血小板计数之间存在很强的正相关（R = 0.730，P < 0.01）。
我们的数据表明，TAM 诊断时较高的血小板计数可能反映了原始细胞异常产生血小板。因此，医生应该意识到在 TAM 患者中，血小板计数和/或原始细胞计数较高的患者可能会出现持续性血小板减少。
