Long-term follow-up of Fanconi anemia: clinical manifestation and treatment outcome

• Published in: Clinical and experimental pediatrics 2014, 57(3), , pp.125-134
• Main Authors: Yoon, Byung Gyu, Kim, Hee Na, Han, Ui Joung, Jang, Hae In, Han, Dong Kyun, Baek, Hee Jo, Hwang, Tai Ju, Kook, Hoon
• Format: Article
• Language: English
• Subjects: Age; Anemia; Birth defects; Blood; Blood platelets; Bone marrow; Chromosomes; Disease; Family medical history; Fanconi anemia; Fibroblasts; Hemoglobin; Korean; Laboratories; Leukemia; Long-term outcome; Medical prognosis; Original; Patients; Siblings; Skin; Standard deviation; Stem cell transplantation; Stem cells; Transplants & implants; 소아과학
• ISSN: 1738-1061; 2092-7258; 2713-4148
• DOI: 10.3345/kjp.2014.57.3.125

The aim of this study was to characterize Korean patients with Fanconi anemia (FA), which is a rare but very challenging genetic disease. The medical records of 12 FA patients diagnosed at Chonnam National University Hospital from 1991 to 2012 were retrospectively reviewed. The median age at diagnosis was 6.2 years. All patients showed evidence of marrow failure and one or more physical stigmata. Chromosome breakage tests were positive in 9 out of 11 available patients. The median follow-up duration was 69.5 months. The Kaplan-Meier (KM) survival of all patients was 83.3% at 10 years and 34.7% at 20 years, respectively. Seven patients underwent 9 stem cell transplantations (SCTs). Among them, 5 were alive by the end of the study. Ten-year KM survival after SCT was 71.4% with a median follow-up of 3.4 years. All 5 patients treated with supportive treatment alone died of infection or progression at the median age of 13.5 years, except for one with short follow-up duration. Acute leukemia developed in 2 patients at 15.4 and 18.1 years of age. Among 6 patients who are still alive, 3 had short stature and 1 developed insulin-dependent diabetes mellitus. We provide information on the long-term outcomes of FA patients in Korea. A nation-wide FA registry that includes information of the genotypes of Korean patients is required to further characterize ethnic differences and provide the best standard of care for FA patients.