{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:16:19Z","timestamp":1758845779464,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1992,8]]},"abstract":"<jats:p>AIMS: To document the features of the so-called aplastic presentation of childhood acute lymphoblastic leukaemia (ALL) and to determine whether this prodrome can be distinguished from aplasia. METHODS: The peripheral blood and bone marrow appearances of all cases of childhood ALL presenting in one health region of England in 13 years and eight months were reviewed. All cases presenting with cytopenia without circulating blasts and marrow aspirates with no infiltrate of blasts were studied in detail. RESULTS: Four of 305 (1.3%) children presented in this way. All four had reticulin fibrosis and increased cellularity in all or part of the marrow biopsy specimen. All were girls. Three had common and one surface membrane immunoglobulin positive ALL. Reassessment of this prodrome, by combining the features of four previously reported series of similar cases with the present one, highlighted the female preponderance (19 of 22 cases), bone marrow fibrosis (10 of 11 evaluable cases), prominent bone marrow lymphocytes (14 of 22 cases) and temporary recovery (all 12 evaluable cases). Six of 14 evaluable cases had bone marrow biopsy specimen appearances of apparently uniform hypocellularity, but only one of these did not have fibrosis. CONCLUSIONS: If, in addition to an aspirate, a bone marrow trephine biopsy is carried out the prodrome can be distinguished from aplasia in most cases. The similarity of this prodrome to aplastic anaemia is merely superficial. Clinicians and morphologists may fail to appreciate the implications of this mode of presentation if the term \"aplastic\" continues to be used to describe this aleukaemic prodrome of ALL.<\/jats:p>","DOI":"10.1136\/jcp.45.8.697","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"697-700","source":"Crossref","is-referenced-by-count":22,"title":["Distinction between aleukaemic prodrome of childhood acute lymphoblastic leukaemia and aplastic anaemia."],"prefix":"10.1136","volume":"45","author":[{"given":"M M","family":"Reid","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G P","family":"Summerfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1992,8,1]]},"reference":[{"issue":"2","key":"ref_1","first-page":"228","article-title":"The varied patterns of aplastic anaemia in childhood","volume":"1961","author":"O'Gorman-Hughes, D.W.","unstructured":"O'Gorman-Hughes DW. The varied patterns of aplastic anaemia in childhood. Aust PaediatrJ 1961;2:228-36.","journal-title":"Aust PaediatrJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/S0022-3476(70)80207-4","article-title":"Acute childhood leukemia presenting as aplastic anemia: The response to corticosteroids","volume":"77","author":"Melhorn, D.K.; Gross, S.; Newman, A.J.","year":"1970","unstructured":"Melhorn DK, Gross S, Newman AJ. Acute childhood leukemia presenting as aplastic anemia: The response to corticosteroids. J Pediatr 1970;77:647-52.","journal-title":"J Pediatr"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"651","DOI":"10.2214\/ajr.116.3.651","article-title":"The value of roentgenography in differentiating aplastic anemia from leukemia masquerading as aplastic anemia","volume":"116","author":"Shackleford, G.D.; Bloomberg, G.; McAlister, W.H.","year":"1972","unstructured":"Shackleford GD, Bloomberg G, McAlister WH. The value of roentgenography in differentiating aplastic anemia from leukemia masquerading as aplastic anemia. Am J Roentgenol Rad Ther 1972;116:651-4.","journal-title":"Am J Roentgenol Rad Ther"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/1097-0142(19810701)48:1<110::AID-CNCR2820480121>3.0.CO;2-R","article-title":"Preleukemic states in children with acute lymphoblastic leukemia","volume":"48","author":"Sills, R.H.; Stockman, J.A.","year":"1981","unstructured":"Sills RH, Stockman JA. Preleukemic states in children with acute lymphoblastic leukemia. Cancer 1981;48: 110-2.","journal-title":"Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1111\/j.1365-2141.1981.tb07241.x","article-title":"MF The aplastic presentation of childhood leukaemia: a feature of common-ALL","volume":"49","author":"Breatnach, F.; Chessells, J.M.; Greaves","year":"1981","unstructured":"Breatnach F, Chessells JM, Greaves MF The aplastic presentation of childhood leukaemia: a feature of common-ALL. Br J Haematol 1981;49:387-93.","journal-title":"Br J Haematol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1111\/j.1365-2141.1988.tb02419.x","article-title":"B-ALL without Burkitt characteristics in children","volume":"69","author":"Reid, M.M.","year":"1988","unstructured":"Reid MM. B-ALL without Burkitt characteristics in children. Br J Haematol 1988;69:574.","journal-title":"Br J Haematol"},{"key":"ref_7","first-page":"9","article-title":"Bone marrow fibrosis in childhood acute lymphoblastic leukaemia","volume":"42","author":"Wallis, J.P.; Reid, M.M.","year":"1989","unstructured":"Wallis JP, Reid MM. Bone marrow fibrosis in childhood acute lymphoblastic leukaemia. J Clin Pathol 1989;42: 9-12.","journal-title":"J Clin Pathol"},{"key":"ref_8","first-page":"159","article-title":"Hematologic and hemopoietic consequences of B 19 parvovirus infection","volume":"25","author":"Young, N.","year":"1988","unstructured":"Young N. Hematologic and hemopoietic consequences of B 19 parvovirus infection. Semin Hematol 1988;25: 159-72.","journal-title":"Semin Hematol"},{"key":"ref_9","first-page":"159","article-title":"Persistent B19 parvovirus infection as a cause of severe chronic anaemia in children with acute lymphocytic leukaemia","volume":"1","author":"Kurtzman, G.J.; Cohen, B.; Meyers, P.; Amunullah, A.; Young, N.S.","year":"1988","unstructured":"Kurtzman GJ, Cohen B, Meyers P, Amunullah A, Young NS. Persistent B19 parvovirus infection as a cause of severe chronic anaemia in children with acute lymphocytic leukaemia. Lancet 1988;ii:1 159-62.","journal-title":"Lancet"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.45.8.697","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T11:15:09Z","timestamp":1758798909000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.45.8.697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,8]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[1992,8,1]]},"published-print":{"date-parts":[[1992,8]]}},"alternative-id":["10.1136\/jcp.45.8.697"],"URL":"https:\/\/doi.org\/10.1136\/jcp.45.8.697","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"type":"print","value":"0021-9746"},{"type":"electronic","value":"1472-4146"}],"subject":[],"published":{"date-parts":[[1992,8]]}}}