Acute arrest of hemopoiesis presenting as severe aplastic anemia: a retrospective analysis

Figures & data

Table 1. The general clinical data of patients with AAH

Number	Age	Sex	Comorbidity	Initial symptoms	Hb (g/L)	WBC (×10^9/L)	ANC (×10^9/L)	PLT (×10^9/L)	Ret (×10^9/L)	Bone marrow hyperplasity	Recovery time (days)
1	46	Male	Thyroid carcinoma	Fever, epistaxis	61	1.16	0.13	2	3.2	Refuse	13
2	57	Female	Hepatitis B	Fever, difficulty swallowing	101	0.52	0.01	9	10.3	Extremely low	12
3	69	Male	Sepsis	Fever	96	0.87	0.02	49	13.7	Extremely low	21
4	44	Male	Suppurative tonsillitis	Fever	93	0.2	0	16	4	Extremely low	15
5	49	Male	Tympanitis	Fever	89	0.6	0.03	31	1.67	Extremely low	15
6	47	Male	Pneumonia	Fever, difficulty swallowing	92	0.2	0.08	124	18	Extremely low	7
7	56	Male	Pneumonia	Fever, difficulty swallowing	105	0.47	0.14	77	16.1	Extremely low	5
8	69	Male	Psoriasis	Hematochezia	42	0.82	0.4	1	3	Extremely low	15
9	69	Female	Pneumonia	Fever, difficulty swallowing	85	0.2	0.04	47	15.8	Extremely low	4
10	53	Female	Psoriasis	Skin ecchymosis	94	2.1	0.69	11	15.3	Low	5
11	21	Male	Suppurative tonsillitis	Fever	77	0.49	0.25	14	19.1	Extremely low	8

Hb, hemoglobin; WBC, white blood cell; ANC: neutrophile granulocyte; PLT: platelet; Ret: reticulocyte

Table 2. The comparison of AAH and SAA on general clinical data

Group	Number	Age	Sex		Initial symptoms		Comorbidity		Bone marrow hyperplasity
			Male	Female	Fever	Hemorrhage	With	Without	Low	Extremely low
AAH	11	53	8	3	9	3	11	0	1	9
SAA	49	37	29	20	11	25	13	36	34	7
p-value	−	.018	.317		0	.137	0		0

Figure 1. The comparison of AAH and SAA on initial symptoms and comorbidities. (A) In the AAH group, the first symptoms mainly included fever (81.8%), bleeding (27.3%), ache (9.1%), difficulty swallowing (27.3%), and anorexia (9.1%), while in the SAA group, the first symptoms were mainly fatigue (42.9%), bleeding (40.8%), fever (22.5%), ache (6.1%), and found in physical examination (6.1%). (B) Patients in the AAH group (n = 11) had complicated diseases including pneumonia (n = 3, 27.3%), psoriasis (n = 2, 18.2%), acute suppurative tonsillitis (n = 2, 18.2%), hepatitis B (n = 1, 9.1%), tympanitis (n = 1, 9.1%), thyroid carcinoma (n = 1, 9.1%), and serious sepsis (n = 1, 9.1%). (C) Patients in the SAA group (n = 49) had complicated diseases including pneumonia (n = 9, 18.4%), psoriasis (n = 1, 2.0%), hepatitis B (n = 1, 2.0%), tympanitis (n = 1, 9.1%), hyperthyroidism (n = 1, 2.0%), hypertension (n = 1, 9.1%), but most of the SAA patients (n = 36, 73.5%) did not have other systemic diseases.

Table 3. The comparison of AAH and SAA on blood routine examination

Group	Number	Hb (g/L)	WBC (×10^9/L)	ANC (×10^9/L)	LYM (×10^9/L)	PLT (×10^9/L)	Ret (×10^9/L)
AAH	11	92 (42−105)	0.52 (0.20−1.16)	0.08 (0−0.69)	0.34 (0.13−1.91)	16 (1−124)	13.70 (1.67−19.1)
SAA	49	70 (23−99)	1.60 (0.20−4.18)	0.25 (0.01−1.00)	1.22 (0.10−3.11)	9 (1−64)	12.10 (0.56−56.10)
p-value	−	.007	.015	.627	.004	0	.466

Hb, hemoglobin; WBC, white blood cell; ANC, neutrophile granulocyte; LYM, lymphocyte; PLT, platelet; Ret, reticulocyte

Table 4. The comparison of AAH and SAA on the iron metabolism indexes

Group	Number	Fe		Ferritin		UIBC		TIBC
		Level (μmol/L)	Elevated number	Level (ng/mL)	Elevated number	Level (μmol/L)	Reduced number	Level (μmol/L)	Reduced number
AAH	11	16.0 ± 2.6	0	1343.8 ± 459.4	8 (100%)	16.0 ± 2.8	5 (71.4%)	31.6 ± 2.2	6 (85.7%)
SAA	49	38.4 ± 1.4	26 (61.9%)	1029.3 ± 124.6	41 (97.6%)	6.7 ± 1.2	39 (92.9%)	45.1 ± 1.2	12 (28.6%)
p-value	−	0		.368		.004		0

UIBC, unsaturated iron binding force; TIBC, total iron binding capacity.

Table 5. The comparison of AAH and SAA on the biochemical indexes

Group	Number	Creatinine		Albumin		LDH
		Level (μmol/L)	Elevated number	Level (g/L)	Reduced number	Level (U/L)	Elevated number
AAH	11	88.0 ± 17.1	1 (9.1%)	32.2 ± 1.9	8 (72.7%)	161.9 ± 28.4	1 (9.1%)
SAA	49	60.9 ± 2.1	0	38.9 ± 1.0	9 (18.4%)	203.6 ± 21.8	7 (16.7%)
p-value	−	.004		.005		.361

LDH, lactic dehydrogenase.

Table 6. The hematopoiesis recovery time of patients with AAH

Number	Age	Sex	Time of ANC in 0.5 ∼ 1 × 10^9/L (days)	Time of ANC >1 × 10^9/L (days)	Time of PLT in 20 ∼ 50 × 10^9/L (days)	Time of PLT >50 × 10^9/L (days)	Time of Ret >20 × 10^9/L (days)	Recovery time (days)
1	46	Male	4	4	6	10	13	13
2	57	Female	6	8	4	8	10	12
3	69	Male	5	6	−	5	19	21
4	44	Male	7	7	7	9	9	15
5	49	Male	3	4	−	1	15	15
6	47	Male	2	5	−	−	7	7
7	56	Male	4	5	−	−	5	5
8	69	Male	5	5	7	13	9	15
9	69	Female	4	4	−	2	4	4
10	53	Female	−	3	5	5	5	5
11	21	Male	4	8	6	8	8	8
Median time			4 (2−7)	5 (3−8)	6 (4−7)	8 (1−13)	9 (4−19)	12 (4−21)