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Congenital bone marrow failure syndromes (BMFSs) are relatively rare disorders characterized by aberrant development in one or more hematopoietic lineages. Genetic alterations have now been identified in most of these disorders although the exact role of the molecular defects has yet to be elucidated. Most of these diseases are successfully managed with supportive care, however, treatment refractoriness and disease progression-often involving malignant transformation-may necessitate curative treatment with hematopoietic stem cell transplantation. Due to the underlying molecular defects, the outcome of transplantation for BMFS may be dramatically different than those associated with transplantation for more common diseases, including leukemia. Given recent improvements in survival and molecular diagnosis of bone marrow failure syndrome patients presenting at adult ages without physical stigmata, it is important for both pediatric and adult hematologists to be aware of the possible diagnosis of BMF syndromes and the unique approaches required in treating such patients.

Congenital bone marrow failure syndromes (BMFSs) are relatively rare disorders characterized by aberrant development in one or more hematopoietic lineages. Genetic alterations have now been identified in most of these disorders although the exact role of the molecular defects has yet to be elucidated. Most of these diseases are successfully managed with supportive care, however, treatment refractoriness and disease progression-often involving malignant transformation-may necessitate curative treatment with hematopoietic stem cell transplantation. Due to the underlying molecular defects, the outcome of transplantation for BMFS may be dramatically different than those associated with transplantation for more common diseases, including leukemia. Given recent improvements in survival and molecular diagnosis of bone marrow failure syndrome patients presenting at adult ages without physical stigmata, it is important for both pediatric and adult hematologists to be aware of the possible diagnosis of BMF syndromes and the unique approaches required in treating such patients.

Ikuko Tsukamoto,1,* Akram Hossain,2,3,* Fuminori Yamaguchi,2 Yuko Hirata,2 Youyi Dong,2 Kazuyo Kamitori,2 Li Sui,2 Machiko Nonaka,2 Masaki Ueno,4 Kazuyuki Nishimoto,5 Hirofumi Suda,5 Kenji Morimoto,6 Tsuyoshi Shimonishi,7,† Madoka Saito,8 Tao Song,9 Ryoji Konishi,1 Masaaki Tokuda2 1Department of Pharmaco-Bio-Informatics, Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan; 2Department of Cell Physiology, Faculty of Medicine, Kagawa University, Kagawa, Japan; 3Matsutani Chemical Industry Co, Ltd, Itami, Japan; 4Department of Inflammation Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan; 5Division of Radioisotope Research, Life Science Research Center, Kagawa University, Kagawa, Japan; 6Rare Sugar Research Center, Kagawa University, Kagawa, Japan; 7IZUMORING LLC, Miki, Kita, Kagawa, Japan; 8Department of Pharmacy, Okayama University Hospital, Okayama, Japan; 9The First Affiliated Hospital, China Medical University, Shenyang, People’s Republic of China *These authors contributed equally to this work†Tsuyoshi Shimonishi has passed away Background: The purpose of this study was to evaluate intestinal absorption, organ distribution, and urinary elimination of the rare sugar D-psicose, a 3-carbon stereoisomer of D-fructose that is currently being investigated and which has been found to be strongly effective against hyperglycemia and hyperlipidemia. Methods: This study was performed using radioactive D-psicose, which was synthesized enzymatically from radioactive D-allose. Concentrations in whole blood, urine, and organs were measured at different time points until 2 hours after both oral and intravenous administrations and 7 days after a single oral administration (100 mg/kg body weight) to Wistar rats. Autoradiography was also performed by injecting 100 mg/kg body weight of 14C-labeled D-psicose or glucose intravenously to C3H mice. Results: Following oral administration, D-psicose easily moved to blood. The maximum