exudates and Anemia--Aplastic

Topics: Anemia, Aplastic; Bone Marrow Transplantation; China; Cooperative Behavior; Family; Hematopoietic Stem Cell Transplantation; Hemoglobinopathies; Hong Kong; Humans; Immunologic Deficiency Syndromes; Leukemia; Lymphoma; Malaysia; Myelodysplastic Syndromes; Peripheral Blood Stem Cell Transplantation; Philippines; Singapore; Thailand; Tissue Donors; Transplantation, Autologous; Transplantation, Homologous

The incidence of aplastic anemia is reported to be higher in Asia than elsewhere. We studied the frequency of human leukocyte antigen (HLA) DRB1 alleles in aplastic anemia patients from 2 genetically similar aboriginal groups, the Kadazan and the Dusun, and compared them with genetically matched community and hospital controls. HLA-DRB1*15 was significantly higher in the patients compared with controls (p = 0.005), confirming similar findings in Japanese and Caucasian studies. Further testing indicated a significantly higher frequency of HLA-DRB1*1501 in patients compared with controls (p = 0.0004) but no significant difference in the frequency of HLA-DRB1*1502. The high frequency of HLA-DRB1*15 in the Kadazan and Dusun population combined with the wide variety of environmental factors associated with aplastic anemia could be the reason for the elevated incidence of aplastic anemia in the Kadazan and Dusun in Sabah.

Topics: Adolescent; Adult; Aged; Alleles; Anemia, Aplastic; Asian People; Case-Control Studies; Female; Gene Frequency; Genetic Association Studies; Genetic Predisposition to Disease; Genotype; Histocompatibility Testing; HLA-DRB1 Chains; Humans; Incidence; Leukocytes; Malaysia; Male; Middle Aged; Phenotype

Topics: Anemia, Aplastic; Benzamides; Chronic Disease; Humans; Imatinib Mesylate; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Malaysia; Male; Middle Aged; Pancytopenia; Piperazines; Pyrimidines; Singapore; Time Factors

Aplastic anaemia is a rare disease which is more prevalent in the Far East. In Malaysia, it appears to be unusually common in the state of Sabah. A retrospective analysis of all cases of aplastic anaemia diagnosed between January 1993 and March 1996 was undertaken. The criteria of the International Aplastic Anaemia and Agranulocytosis Study (IAAAS) was used. In this 39 month period, 31 cases were confirmed by marrow trephine biopsy to be aplastic anaemia. The male-to-female ratio was 3.4. Median age of diagnosis was 23 years. There were 24 patients (77%) who were from the Kadazan-Dusun ethnic group, which forms 18% of the population of Sabah. The incidence of aplastic anaemia in Sabah appears to be higher than that reported elsewhere in the Far East, at 4.8 per million population per year. Peak incidence is in the elderly group at 8.6 per million followed by a second peak in young people aged 15 to 24 (7.9 per million). The aplastic anaemia to total acute leukaemia ratio is 0.37. The marked male preponderance and apparent susceptibility of the Kadazan-Dusun people are also notable. A further prospective study to address the true incidence of aplastic anaemia and possible aetiologic factors accounting for these observations is necessary.

Topics: Adolescent; Adult; Age Factors; Aged; Anemia, Aplastic; Child; Child, Preschool; Female; Humans; Incidence; Infant; Infant, Newborn; Malaysia; Male; Middle Aged; Retrospective Studies; Sex Factors