高齢者再生不良性貧血の病態並びに治療に関する臨床的研究

To evaluate hypoplastic anemia (HA) in the aged, clinical and hematological findings of 88 patients with HA were analyzed. The patients were classified into 4 groups according to age (Group A : 5-24 y/o, Group B : 25-44 y/o, Group C : 45-64 y/o and Group D : 65 y/o- ). Hematological findings of patients in Group D were also compared to those of aged patients (above 65 y/o) with myelodisplastic syndrome (MDS) to clarify differentiation of HA from MDS. Items studied were severity, therapeutic response, complications, hematological findings, survival period and cause of death. The following results were obtained : 1. HA in the aged was frequently severe. 2. Responses to therapies including anabolic steroids and corticosteroids tended to be poor in the aged compared to those in younger patients. 3. Infections and diabetes mellitus were frequently observed complications in the aged. 4. Mortality in the aged was higher than that in younger patients. 57.1% of the aged died from bleeding. 5. The survival period of patients in Group C and D was shorter than that of patients in Group A and B. 6. Red blood cell count, reticulocytes and hemoglobin level in the aged were significantly lower than those in younger patients. Neutrophil and monocyte counts in the aged tended to be lower than those in younger patients. Nucleated cell counts and percentages of granulocytes and erythroblasts in the marrow were also lower in the aged. 7. The incidence of atypical hematological findings in HA were not different between the aged and younger patients. 8. In a comparison of HA in Group D and MDS in the aged, patients with HA showed severe anemia and thrombocytopenia.