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Category: Volume 05 Issue 08 August 2017
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Title: Estimation of CD34+ in Patients with Hypocellular Marrow and Treatment Response in Aplastic Anemia

Authors: Ratnamala Choudhury, Shruthi Kulkarni, Arun Alex, Sitalakshmi S, Cecil Ross

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.199

Abstract

Introduction: Hypoplastic myelodysplastic syndrome (hMDS) is morphologically difficult to be distinguished from acquired aplastic anaemia (AA). Response to treatment of AA varies based on the treatment used and duration of follow up. we conducted a prospective study to estimate bone marrow CD 34 cells on hypoplastic marrows (AA and hMDS) and evaluated the haematologic response to treatment in aplastic anaemia.

Methods: We conducted a prospective study in patients with hypocellular BM due to either acquired AA or hMDS. The CD34+cells in the bone marrow were estmated by immunohistochemistry (IHC) prior to treatment. We assessed treatment response to immunosuppressive therapy in patients with AA.

Results: We followed up 53 patients with AA for a minimum of 3 months. Out of 53 patients with AA, 34 (64%) had low CD34+ level, 17 (32%) had normal and 2 (4%) had high CD34+ levels. 34 (64%) patients were on cyclosporine, 14 (26%) patients were on androgens, 3(5.6%) patients received ATG regime and 2(4.4%) patients received blood and blood products alone. At the end of 3 months, 20 (39%) patients showed partial response while the remaining 31 (61%) patients were nonresponders, irrespective of the treatment category.

Conclusion: In conclusion, majority of the patients with AA had low CD34 cells at baseline in our study. The response to treatment varies widely based on the type of treatment. There was no difference in treatment response, irrespective of treatment category based on the CD34 cells at baseline among patients with low and normal CD 34 cells.

Keywords: Aplastic anemia, hypocellular myelodysplastic syndrome (hMDS), CD 34+, immunosuppressive therapy, treatment response.

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Corresponding Author

Shruthi Kulkarni

Assistant Professor, Dept of Medicine,

St. John’s Medical College Hospital, Sarjapur road, Bangalore-34

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