Ferrokinetic studies and prognosis in aplastic anaemia

In a study of 16 patients with aplastic anaemia, an attempt has been made to relate ferrokinetic data to haematological measurements and clinical course. There was a positive relationship of cellularity on trephine biopsy with plasma iron clearance and erythrocyte iron turnover, but not with red cell utilisation. Bone marrow aspirate provided less reliable information on erythropoietic function than did trephine biopsy. There was good correlation between all the ferrokinetic parameters and reticulocyte count, but not between reticulocyte count and marrow cellularity, even by trephine. Patients whose ferrokinetic studies indicate a less severe erythroid depression (i.e., plasma clearance T 1/2 less than 200 min and red cell utilisation greater than 35%) are more likely to survive without transplantation than those with more abnormal ferrokinetic results, but such studies alone are of only limited value in clinical management of the individual patient.