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Drug-Related Blood Dyscrasias

Charles M. Huguley, Jr., M.D.; Allan J. Erslev, M.D.; Daniel E. Bergsagel, M.D.
[+] Author Affiliations

Article submitted at the request of the Study Group on Blood Dyscrasias of the Council on Drugs, American Medical Association.


Atlanta, Ga.; Philadelphia, Pa.; Houston, Tex.

Associate Professor of Medicine, Emory University School of Medicine (Dr. Huguley); Associate Professor of Medicine, Jefferson Medical College (Dr. Erslev); Associate Hematologist, Department of Medicine; University of Texas, M. D. Anderson Hospital & Tumor Institute (Dr. Bergsagel).


JAMA. 1961;177(1):23-26. doi:10.1001/jama.1961.73040270010004a
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A registry, established to study blood dyscrasias that might be related to drugs, received 448 reports of such cases during the year 1960. There were 97 cases of pancytopenia. Among the 31 cases in which a single drug was implicated, 5 drugs were associated with more than 1 case: chloramphenicol, methyl-phenylethyl-hydantoin, phenylbutazone, and the 2 insecticides, gamma benzene hexachloride and chlordane. There were 44 cases of thrombocytopenia, and among the 16 cases in which a single drug was implicated the one most frequently involved was quinidine (5 cases). Among 93 cases of leukopenia there were 8 in which chlorpromazine was the only drug implicated. It is evident that certain drugs must be used only if the physician is alert, and alerts his patient, to the fever, sore throat, weakness, pallor, or bleeding that may be the first sign of developing blood dyscrasia.

REFERENCES

 Blood Dyscrasias Associated with Chlorpromazine Therapy , JAMA 160:287 ( (Jan. 28) ) 1956;.
 Blood Dyscrasias Associated with Promazine Hydrochloride Therapy , JAMA 165:685-686 ( (Oct. 12) ) 1957;.
 Development and Purpose of Registry of Blood Dyscrasias , JAMA 170:1925-1926 ( (Aug. 15) ) 1959;.
 Blood Dyscrasias Associated with Chloramphenicol (Chloromycetin) Therapy , JAMA 172:2044-2045 ( (April 30) ) 1960;.
Welch, H.; Lewis, C. N.; and Kerlan, L.:  Blood Dyscrasias: Nationwide Survey , Antibiot Chemother 4:607-623 ( (June) ) 1954;.
Beutler, E.:  Drug-Induced Hemolytic Anemia , in Metabolic Basis of Inherited Disease , edited by J. B. Stanbury, J. B. Wyngaarden, and D. S. Fredrickson, New York: McGraw-Hill Book Company, 1960;, pp. 1031-1067.
Harris, J. W.:  Studies on Mechanism of Drug-Induced Hemolytic Anemia , J Lab Clin Med 47:760-775 ( (May) ) 1956;.
Freedman, A. L.; Barr, P. S.; and Brody, E. A.:  Hemolytic Anemia Due to Quinidine: Observations on Its Mechanism , Amer J Med 20:806-816 ( (May) ) 1956;.
Ackroyd, J. F.:  Role of Sedormid in Immunologic Reaction that Results in Platelet Lysis in Sedormid Purpura , Clin Sci 13:409-423 ( (Aug.) ) 1954;.
Moeschlin, S., and Wagner, K.:  Agranulocytosis Due to Occurrence of Leukocyte-Agglutinins , Acta Haemat 8:29-41 ( (July) -Aug.) 1952;.
Gale, E. F., and Folkes, J. P.:  Assimilation of Amino Acids by Bacteria: 15. Actions of Antibiotics on Nucleic Acid and Protein Synthesis in Staphylococcus Aureus , Biochem J 53:493-498 ( (Feb.) ) 1953;.
Brock, T. D.:  Chloramphenicol , Bact Rev 25:32-48 ( (March) ) 1961;.
Krakoff, I. H.; Karnofsky, D. A.; and Burchenal, J. H.:  Effects of Large Doses of Chloramphenicol on Human Subjects , New Engl J Med 253:7-10 ( (July 7) ) 1955;.
Rubin, D.; Weisberger, A. S.; Botti, R. E.; and Storaasli, J. P.:  Changes in Iron Metabolism in Early Chloramphenicol Toxicity , J Clin Invest 37:1286-1292 ( (Sept.) ) 1958;.
Ozer, F. L.; Truax, W. E.; and Levin, W. C.:  Erythroid Hypoplasia Associated with Chloramphenicol Therapy , Blood 16:997-1001 ( (July) ) 1960;.
Rosenbach, L. M.; Caviles, A. P.; and Mitus, W. J.:  Chloramphenicol Toxicity: Reversible Vacuolization of Erythroid Cells , New Engl J Med 263:724-728 ( (Oct. 13) ) 1960;.
Saidi, P.; Wallerstein, R. O.; and Aggeler, P. M.:  Effect of Chloramphenicol on Erythropoiesis , J Lab Clin Med 57:247-256 ( (Feb.) ) 1961;.
Unpublished Report.

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 Blood Dyscrasias Associated with Chlorpromazine Therapy , JAMA 160:287 ( (Jan. 28) ) 1956;.
 Blood Dyscrasias Associated with Promazine Hydrochloride Therapy , JAMA 165:685-686 ( (Oct. 12) ) 1957;.
 Development and Purpose of Registry of Blood Dyscrasias , JAMA 170:1925-1926 ( (Aug. 15) ) 1959;.
 Blood Dyscrasias Associated with Chloramphenicol (Chloromycetin) Therapy , JAMA 172:2044-2045 ( (April 30) ) 1960;.
Welch, H.; Lewis, C. N.; and Kerlan, L.:  Blood Dyscrasias: Nationwide Survey , Antibiot Chemother 4:607-623 ( (June) ) 1954;.
Beutler, E.:  Drug-Induced Hemolytic Anemia , in Metabolic Basis of Inherited Disease , edited by J. B. Stanbury, J. B. Wyngaarden, and D. S. Fredrickson, New York: McGraw-Hill Book Company, 1960;, pp. 1031-1067.
Harris, J. W.:  Studies on Mechanism of Drug-Induced Hemolytic Anemia , J Lab Clin Med 47:760-775 ( (May) ) 1956;.
Freedman, A. L.; Barr, P. S.; and Brody, E. A.:  Hemolytic Anemia Due to Quinidine: Observations on Its Mechanism , Amer J Med 20:806-816 ( (May) ) 1956;.
Ackroyd, J. F.:  Role of Sedormid in Immunologic Reaction that Results in Platelet Lysis in Sedormid Purpura , Clin Sci 13:409-423 ( (Aug.) ) 1954;.
Moeschlin, S., and Wagner, K.:  Agranulocytosis Due to Occurrence of Leukocyte-Agglutinins , Acta Haemat 8:29-41 ( (July) -Aug.) 1952;.
Gale, E. F., and Folkes, J. P.:  Assimilation of Amino Acids by Bacteria: 15. Actions of Antibiotics on Nucleic Acid and Protein Synthesis in Staphylococcus Aureus , Biochem J 53:493-498 ( (Feb.) ) 1953;.
Brock, T. D.:  Chloramphenicol , Bact Rev 25:32-48 ( (March) ) 1961;.
Krakoff, I. H.; Karnofsky, D. A.; and Burchenal, J. H.:  Effects of Large Doses of Chloramphenicol on Human Subjects , New Engl J Med 253:7-10 ( (July 7) ) 1955;.
Rubin, D.; Weisberger, A. S.; Botti, R. E.; and Storaasli, J. P.:  Changes in Iron Metabolism in Early Chloramphenicol Toxicity , J Clin Invest 37:1286-1292 ( (Sept.) ) 1958;.
Ozer, F. L.; Truax, W. E.; and Levin, W. C.:  Erythroid Hypoplasia Associated with Chloramphenicol Therapy , Blood 16:997-1001 ( (July) ) 1960;.
Rosenbach, L. M.; Caviles, A. P.; and Mitus, W. J.:  Chloramphenicol Toxicity: Reversible Vacuolization of Erythroid Cells , New Engl J Med 263:724-728 ( (Oct. 13) ) 1960;.
Saidi, P.; Wallerstein, R. O.; and Aggeler, P. M.:  Effect of Chloramphenicol on Erythropoiesis , J Lab Clin Med 57:247-256 ( (Feb.) ) 1961;.
Unpublished Report.
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