Refractory Cytopenia of Childhood (RCC)

Peripheral blood findings:

(1) cytopenias

(2) macrocytic erythrocytes

(3) increased fetal hemoglobin

(4) < 2% blasts

Bone marrow features:

(1) hypocellular bone marrow

(2) micromegakaryocytes

(3) dysplastic features in one or more lineages

(4) < 5% blasts

(5) erythroid islands (clusters of > 10 erythroid precursors)

Risk factors for disease progression (Hasegawa et al):

(1) monosomy 7

(2) multilineage dysplasia

Differential diagnosis:

(1) aplastic anemia