Identification of high-risk patients with aplastic anaemia in selection for allogeneic 0one-marrow transplantation
Lohrmann, H.P.; Kern, P.; Niethammer, D.; Heimpel, H.
Lancet 2(7987): 647-650
1976
ISSN/ISBN: 0140-6736 PMID: 60514 Document Number: 109488
Of 75 patients with aplastic anemia treated between 1968 and 1975, 33 were retrospectively considered as potential candidates for allogeneic bone-marrow transplantation on the basis of their age and severity of marrow failure. The prognosis of these patients with conservative treatment was assessed from parameters obtained at the time of the initial diagnosis. Initial peripheral-blood granulocyte or platelet concentrations were not of prognostic value. In contrast, initial reticulocyte concentrations allowed separation of the patients into 2 groups with poor and good prognosis. Low initial reticulocyte concentrations (less than 10,000/.mu.l) indicated those patients at extremely high risk of succumbing to their marrow aplasia (there were no survivors 36 mo. after diagnosis). In contrast, 75% of those patients with more than 10,000 reticulocytes per .mu.l at diagnosis survived for 3 yr. Initial peripheral-blood reticulocyte concentrations apparently indicate the extent of the marrow failure in aplastic anemia more accurately than granulocytes or platelets. Low initial reticulocyte concentrations may indicate, among patients with severe aplastic anemia, those for whom allogeneic bone-marrow transplanation should be seriously considered; patients with higher initial reticulocyte concentrations may benefit from conservative treatment.