A hematological study on the 161 cases of aplastic anemia was done emphasising the
correlation between the bone marrow finding and the etiological background and
hematological values.
The cases involved in this study were selected from the accumulated cases during a
period of 13 years from 1960 to 1973, in the Department of Clinical Patholsgy, College of
Medicine, Seoul National University.
The results are summerized as follows.
1. Age distribution of aplastic anemia was highest in 10 to 19 years of age group and
male to female ratio was l.6 : 1.
2. Idiopathic type of unknown etiology was 75.2 percent of the total 161 cases and the
most common etiological agents suggested in secondary type were benzene (5%),
chloramphenicol (5%), herb medicines (5%), and the antibiotics other than
chloramphenicol (3.7%)
3. Anemia was the most commonly encountered initial symptom with the hematocrit
value of 0∼19 volume percent in 53% and hemoglobin value of 0∼5.9gm/dl in 50% of
the total aplastic anemia patient respectively. The initial value of corrected reticulocyte
count was less than 0.55 percent in 77 percent of total cases.
4. Initial WBC count was ]ess than 2,000/mm3 in 24% of total cases,
however the lowest WBC count during hospital course was less than
2,000/mm3 in 45 percent of total cases.
5. Initial platelet count was less than 30,000/mm3 in 29 percent and only
19 percent of total cases showed more than 100,000/mm3. The lowest
platelet count during hospital course was less than 30,000/mm3 in 45
percent and more than 100,000/mm3 in 10 percent of the total cases
respectively.
6. The cellularity of bone marrow was normocellular to hypercellular in 14 percent and
the remaining cases were hypocellular to aceilular. Total nucleated cells and immature
granulocytes are decreased in reverse proportion to the increase of lymphocytes. There
was no definite relationship between the number of normoblast and the cellularity of
bone marrow, but the number of lymphocytes and plasma cells were significantly
increased in hypocellular marrow.
7. Tissue basophils and reticulum cells were more frequently encountered in
hypersensitivity type and especially in hypocellular type of marrow.
8. Some cases of aplastic anemia due to herb medicine showed an increased number of
tissue basophils and reticulum cells in bone marrow. In summary, the bone marrow
findings of the aplastic anemia, especially those of hypersensitivity type showed an
increased number of lymphocytes, plasma cells, tissue basophils and reticulum cells
strongly suggesting the immunologic reactions in the initiation of aplastic anemia.
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