Bessman J D, Gardner F H
Arch Intern Med. 1985 Feb;145(2):293-6.
Sixteen adults with chronic acquired aplastic anemia had abnormally large RBCs and abnormally small platelets before chemotherapy. During their therapy, transfusion initially obscured these macrocytic RBCs. In the eight who had erythropoietic recovery, endogenous RBCs again were macrocytic, and platelets remained small whether or not the platelet count increased. The percentage of cells containing hemoglobin F changed in only one of the eight subjects. In contrast, the eight who did not have erythropoietic recovery had no reappearance of macrocytes. Of 19 other previously treated patients whose hemoglobin level had recovered to normal for seven to 196 months, 16 had increased mean corpuscular volume (101 to 133 femtoliters) and abnormally small platelets. We conclude that in aplastic anemia the appearance of macrocytes reliably and easily predicts RBC recovery. Furthermore, even in treated, apparently recovered subjects, an abnormality of blood cell size remains.
16名慢性获得性再生障碍性贫血成年患者在化疗前红细胞异常增大，血小板异常减小。在治疗期间，输血最初掩盖了这些大红细胞。在8例有红细胞生成恢复的患者中，内源性红细胞再次呈大细胞性，无论血小板计数是否增加，血小板仍保持较小。8名受试者中只有1名含血红蛋白F的细胞百分比发生了变化。相比之下，8例没有红细胞生成恢复的患者未再次出现大红细胞。在其他19例先前接受治疗、血红蛋白水平已恢复正常7至196个月的患者中，16例平均红细胞体积增加（101至133飞升），血小板异常减小。我们得出结论，在再生障碍性贫血中，大红细胞的出现可靠且容易地预测红细胞恢复。此外，即使在经过治疗且明显康复的受试者中，血细胞大小异常仍然存在。
