Sponsored by the Korean Society of Hematology as an annual academic project in
1974, this survey was carried out to obtain collective and authentic informations on
aplastic anemia among Korean populations.
Sufficient number of printed blank forms (Fig.1 & 2) were sent to major hospitals
throughout the nation. and 16 of these responded in time for the collective
analysis(Table 1).
Recognizing the fact that still there were lack of uniformity concerning the concept of
aplastic anemia, no screening of the collected cases was performed, and all of the 862
cases submitted for this survey were included in the analysis.
The results obtained were as follows.
1. The sex and age distributions were summarized in Table 3. Of the total 862 cases
the pediatric age group (0-14 years) occupied 30.0%, from 15 to 49 years 58.1%, and 50
years or over 11.9%
The youngest age was 1 week old female, and oldest was 73 years old female. Male
to female ratio was l.7:1.
2. As found in the Table 4, the city to non-city ratio on the basis of the present
address was 1.82 : 1. However, this higher prevalence of the city dwellers was to be
attributed at least partly to the concentrated localization of the participating hospitals in
the cities.
3. The exposure to the chemical substances which was judged to be probably (or
possibly) related to the development of aplastic anemia are listed in Table 6.
Chloromycetin marked the highest number of 87 cases, followed by herb medicine 42,
benzene 27, parathion 24 and so forth. Antibiotics including cholormycetin totaled 117
cases. Insecticide including parathion,"Farm chemicals" and Lindane totaled 55 cases. As
to the role of herb medicine for the pathogenesis of aplastic anemia, further systematic
and intensive studies were felt necessary, particulary in view of the large population
exposed to this therapeutics in Korea
4. Among the clinical manifestation the analysis of fever was summarized in Table 7,
and bleeding tendencies in Table 8. Lymphnode enlargements were found in 6.5% of all
cases in which pediatric age group showed 12.4% (Fig. 9). It was speculated that this
lymphnode enlargement was at least partly due to reactive hyperplasia caused by
microbial infection secondary to the decreased granulocytes. Hepatomegaly was observed
in 18.3% of all cases. This figure was somewhat higher than our expectation (Table 10),
In the discussion it was reminded that this collective analysis did not exclude the
possibility of other diseases, ccmplicated either incidentally (such as clonorchiasis) or
related pathogenetically (such as viral hepatitis). Splenomegaly was found in 9.2% of all
cases (Table 11), however because of the limited clinical data further analysis and
estimation of the disease stage were difficult..
5. Among the laboratory findings, the hemoglobin showed less than 5gm/dl in 44.9%,
and less than 8gm/dl in 81.7% of the cases recorded (Table 12). The hematocrit showed
below 15% in 42.1%, and no more than 24% in 81.0% of the cases (Table 13). The
reticulocyte counts were below 0.5% for 47.7% of cases,.and below 1.5% for 81.7% of
the cases record. However, 5.3% of the cases showed over 3.0% (Table 14). The
analysis of leukoeyte counts revealed below 2,000/㎣ for 22.9%, and below 4, 000/㎣ for
73.9% of the cases recorded (Table 15). The platelet counts revealed (Table 16).The
coagulation time was prolonged in 47.2% of the cases recorded (Table 17), and the
bleeding time was prolonged in 69.2% of the cases recorded (Table 18). The serum iron
was above 150㎍/dl in 66.8% of the cases recorded (Table 19). and the percentage of
saturation of total iron binding capacity was above 45% in 68.7% of the cases recorded
(Table 21).
6. The analysis of bone marrow findings revealed hypocellularity in 84.8%,
normocellularity in 5.5%, hypercellularity in 7.7% and "dry tap" in 2.0% of the 762 cases
recorded(Table 22). Of the 136 cases in which estimated percentages of bone marrow
celluarity were recorded, 93.4% showed less than 30% in cellularity (Table 23).
7. The analysis of the follow up revealed, cured or improved in 36.6%, unchanged in
40.6% worsen in 7.8% and dead in 15.0% of the cases recorded (Table 24).
8. The analysis of therapy was summarized in Table 25. In order of frequency it
consisted of corticosteroid, blood transfusion, folic acid, testosterone antibiotics,and so
forth. Five cases of splenectomy was also found.
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