Clinical features of 25 patients with aplastic anemia

We experienced 27 patients with aplastic anemia (AA) during the period of 1984 to 1988. Of these, clinical characteristics of 25 patients who were followed up until death or at least for 2 years were evaluated. In terms of the degree of the initial hematological impairment, the patients were separated into 3 groups: 9 (36%) in severe, 11 (44%) in moderate, and 5 (20%) in mild impairment. The survival rates in 24 months after diagnosis were 44% in severe, 64% in moderate, and 100% in mild, indicating close relation between the degree of the initial hematological impairment and survival rates. 9 patients in a severe group received blood transfusion, anabolic steroids and/or high-dose corticosteroids, but these treatments resulted in an unsatisfactory outcome. It is suggested that they need other therapeutic modalities, including bone marrow transplantation. When the initial hematological data were compared between a group of patients who were alive for more than two years and a group of patients who died within two years, the mean granulocyte counts and reticulocyte counts of these two groups showed significant differences. However, the mean platelet counts were not significantly different. This indicates that the initial granulocyte count and reticulocyte count are indicators of prognosis in AA, and that the initial platelet count does not influence the prognosis.