Long-term prognosis and residual abnormalities of idiopathic acquired aplastic anemia in children.

We evaluated the long-term prognosis and quality of cure of idiopathic acquired aplastic anemia in children. Of the 244 patients registered from 1965 to 1985, those registered in 1965-1975 and 1976-1985 had a survival rate of 50.1% and 62.0%. The percentage of cure, undertreatment and death was 30, 30 and 40%, respectively. About 40% of the patients with moderate cases, died dead or required frequent blood transfusions. In the case of pediatric patients, as the success rate of bone marrow transplantation was high. This modality should be considered for patients with moderate severity who require blood transfusion 3 months after the diagnosis and an HLA identical donor is available. Physical development was almost normal but 35% of the patients showed residual abnormalities such as bleeding tendency, and hepatic disorders due to treatment. Thrombocytopenia and ineffective hematopoiesis were observed in one-third of the patients and all of the patients showed abnormal committed stem cell assay. The CD 4/8 ratio was reduced in 50% of the patients and 15% exhibited psychological problems. These residual abnormalities last for years, and sometimes a lifetime.