Acquired aplastic anaemia in adults. I. A retrospective analysis of 40 cases: single factors influencing the prognosis.

In a retrospective analysis of 40 aplastic anaemia patients, an attempt was made to determine prognostic parameters permitting discrimination between short survivors (less than 6 months) and long-term survivors (greater than 6 months). Short survival proved to be significantly associated with a persistently low reticulocyte index and progressive neutropenia. Other factors such as bone marrow cellularity, HBF level, aetiology, or presenting signs were not indicative. Chromosomal aberrations were found in one third of the cases examined, but none had developed into a leukaemic stage after an observation period of 2--5 years. None of the patients with cytogenetic aberrations showed complete restoration of haematopoiesis, in contrast to several of the patients without chromosomal abnormalities. In this series, drug-associated aplastic anaemia was found more often in the short-survival group. These clinical findings indicate that the term 'aplastic anaemia' covers a heterogenous group of disorders.