Gold induced marrow suppression: a review of 10 cases

We have reviewed 10 cases of gold sodium aurothiomalate (GSTM) induced marrow suppression. All had biopsy proven marrow hypoplasia/aplasia. Anemia, neutropenia and thrombocytopenia were observed in 7 of the 10 patients. In 2 patients, hypoplastic marrow was associated with suppression of 2 of the formed elements of the blood, while in one patient, there was isolated neutropenia. Nine of the 10 patients survived. Bone marrow recovery occurred within an average of 5.4 months. A response was seen in 3 with antithymocyte globulin. One patient required an allogeneic bone marrow transplant. A combination of corticosteroids and androgens was associated with recovery in 5. Blood and platelet transfusions and antibiotics were instituted only when clinically indicated. We conclude that the prognosis of GSTM induced marrow suppression is better than previously reported.