• Ayesha Ehsan
  • Shahida Amjad Riaz Shah
  • Tayyaba Ibrahim


Background: Acquired aplastic anaemia is a rare disease which results in morbidity and mortalityat a young age. This study was carried out to determine the clinical presentation, haematologicalparameters and association factors of acquired aplastic anaemia in a cohort of Pakistani patients.Methods: This was a cross-sectional study conducted at Haematology Department, Shaikh ZayedHospital, Lahore over 7 years from June 2000 to July 2007. Eighty-two patients of acquiredaplastic anaemia were enrolled in the study by non-probability purposive sampling. Theirdiagnosis was confirmed by complete blood count, bone marrow aspirate and trephine biopsy. Thecohort was classified on the basis of severity and the epidemiological, clinical and haematologicalparameters were analysed. Results: Of the 82 enrolled patients of acquired aplastic anaemia, 49(59.8%) were males and 33 (40.2%) were females. Mean age of the patients was 27.93±18.7 yearswith a range of 1–80 years. The male to female ratio was 1.48:1. Bone marrow cellularity was lessthan 25 % in 31 (38.0%) cases and between 25–30% in 51 (62%) of patients. Most of the caseswere clinically severe aplastic anaemia (68%). In 62 (76%) of the cases no association factorspredisposing to aplastic anaemia could be identified. Conclusion: Acquired Aplastic anaemia is adisease of all ages. In the second decade and the elderly predominantly severe clinical stages wereseen. Males presented at a younger age while females presented at all ages with a somewhatsimilar incidence. No association factors of Aplastic Anaemia could be identified in majority ofthe patients.Keywords: Aplastic anaemia, epidemiology, clinical staging


Locasciulli A. Acquired aplastic anemia in children: incidence,

prognosis and treatment options. Paediatr Drugs 2002;4(11):761–6.

Young NS, Calado RT and Scheinberg P. Current concepts in the

pathophysiology and treatment of aplastic anemia. Blood

;108(8): 2509–19.

Montané E, Ibáñez L, Vidal X, Ballarín E, Puig R, García N,

Laporte JR. Epidemiology of aplastic anemia: a prospective

multicenter study. Haematologica 2008;93(4):518–23.

McCahon E, Tang K, Rogers PC, McBride ML, Schultz KR. The

impact of Asian descent on the incidence of acquired severe

aplastic anemia in children. Br J Haematol 2003;121:170–2.

British Committee for Standards in Haematology (BCSH)

General Haematology Task Force. Guidelines for the diagnosis

and management of acquired aplastic anemia. Br J Haematol


Adil SN, Burney IA, Kakepoto GN, Khurshid M. Epidemiologic

features of aplastic anemia in Pakistan. J Pak Med Assoc


Young NS, Scheinberg P, Calado RT. Aplastic Anaemia. Curr

Opin Hematol 2008;15(3):162–8.

Saqib Malik, Iram Sarwar, Tariq Mehmood, Farhat Naz.

Aetiological considerations of acquired aplastic anemia. J Ayub

Med Coll Abottabad 2009;21(3):127–30.

Lu J, Basu A, Melenhorst J, Young NS, Brown KE. Analysis of

T-cell repertoire in hepatitis-associated aplastic anemia. Blood.


Guinan EC, Shimamura A. Acquired and Inherited aplastic

anemia syndromes. In: Green JP, Rodgers GM, Foester J,

Paraskevas F, Lukens JN, Glader B, editors. Wintrobe’s Clinical

Haematology. 11th ed. Philadelphia: Lippincott Williams &

Wilkins; 2004:1397–419.

Bennett JM, Orazi A. Diagnostic criteria to distinguish

hypocellular acute myeloid leukemia from hypocellular

myelodysplastic syndromes and aplastic anemia:

recommendations for a standardized approach. Haematologica


Issaragrisil S, Kaufman DW, Anderson T, Chansung K,

Leaverton PE, Shapiro S, et al. The epidemiology of aplastic

anemia in Thailand. Blood 2006;107:1299–307.

Hanif S, Naz F, Siddiqui E, Raza J. Acquired Aplastic anemia:

Treatment in a developing country. Pak J Med Sci 2007;23:37–4.

Hassan K. Severe Aplastic Anemia- An aetiological correlation. J

Pak Med Assoc1994;44:43–5.

Gupta V, Tripathi S, Singh TB, Tilak V, Bhatia BD. A study of

bone marrow failure syndrome in children. Indian J Med Sci


Brown KE, Tisdale J, Barrett AJ, Dunbar CE, Young NS.

Hepatitis-associated aplastic anemia. N Engl J Med


Ahamed M, Anand M, Kumar A, Siddiqui MK. Childhood

aplastic anemia in Lucknow, India: incidence, organochlorines in

the blood and review of case reports following exposure to

pesticides. Clin Biochem 2006;39:762–6.

Issaragrisil S, Chansung K, Kaufman DW, Sirijirachai J,

Thamprasit T, Young NS. Aplastic anemia in rural Thailand: its

association with grain farming and agricultural pesticide

exposure. Aplastic Anemia Study Group. Am J Public Health


Perkins SL. Normal blood and bone marrow values in humans.

In: Green JP, Rodgers GM, Foester J, Paraskevas F, Lukens JN,

Glader B, editors. Wintrobe’s Clinical Haematology. 11th ed.

Philadelphia: Lippincott Williams & Wilkins; 2004:2697–706.