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A Syndrome of Anaemia, Thrombocytopenia and Subnormal Granulocyte Function in Elderly Patients
Author(s) -
Berg B.,
Brandt L.
Publication year - 1973
Publication title -
scandinavian journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0036-553X
DOI - 10.1111/j.1600-0609.1973.tb00054.x
Subject(s) - medicine , platelet , phagocytosis , splenectomy , myeloid , bone marrow , gastroenterology , immunology , spleen
An impaired phagocytic capacity of the neutrophilic leucocytes was found in 4 elderly patients with anaemia, thrombocytopenia and normal white blood counts. Leucocyte alkaline phosphatase activity was subnormal, and in 3 of the patients the morphology of the granulocytes was abnormal with a low degree of nuclear segmentation and an exaggerated clumping of the chromatin. In all patients the bone marrow was hypercellular with an increased myeloid/erythroid ratio. Besides anaemia and an increased tendency to bleeding, a high susceptibility to infections was observed. There were no initial signs of leukaemia, nor was the syndrome compatible with any other conventional haematologic diagnosis. In one patient myeloblastic leukaemia was diagnosed after 8 months of observation and in another signs of chronic myeloid leukaemia developed after 5 months. The syndrome may therefore be preleukaemic. Attempts to improve the condition with steroids, cytostatic drugs, splenectomy, and androgens were unsuccessful. In two patients the phagocytic capacity of the neutrophilic leucocytes was repeatedly enhanced during oral administration of clofazimine, a phenazine derivative with a phagocytosis‐promoting effect. The prognosis was grave, 3 patients being dead within 10 months.