In Japan, prospective multi-center studies have been conducted for childhood 4plastic anemia (AA) since 1993 and data on more than 500 patients have been accumulated. The outcome of both immunosuppressive therapy and allogeneic bone marrow transplantation, particularly in unrelated donor settings, have significantly improved . The long -term survival rate in childhood AA exceeded 90% in the recent decade . Although our previous study reported an extremely high incidence of secondary

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... tic syndrome (MDS) and acute myeloid leukemia (AML) after combination of immunosuppressive agents and granulocyte colony-stimulating factor, the current study revealed a prominent decrease in the incidence of MDS/AML with monosomy 7 after the start of prospective multi-center studies .