guidebook. - Fanconi Anemia Research Fund

54
Fanconi Anemia: Guidelines for Diagnosis and Management
cytogenetic abnormality and the onset of MDS or frank
leukemia and to identify the presence of cytogenetic
abnormalities that may demand immediate intervention.
Annual evaluation of the bone marrow allows for comparison
of a patient’s marrow to previous specimens
from the same patient. The availability of serial marrow
specimens facilitates assessment of the progression of
that patient’s marrow and allows for more informed
decisions about the significance of a clonal abnormality.
Recommendations for clinical monitoring are summarized
below (Table 2):
Table 2: Clinical Monitoring of Bone Marrow Failure
Normal/mild
marrow failure
Blood counts stable*
yes
no
Marrow clonal
abnormality**
or significant dysplasia
yes
no
Marrow evaluation
Then:
Blood counts:
every 1-2 months
Marrow:
every 3-6 months
Blood counts:
every 1-2 months
Marrow:
every 1-6 months
Blood counts:
every 3-4 months
Marrow:
every year
NOTE: Refer to text
for full discussion.
*Persistent drop or rise in blood counts without apparent cause warrants bone marrow
evaluation.
**Specific clonal abnormalities may warrant immediate treatment intervention or
closer monitoring.