DRUG-USE AND APLASTIC-ANEMIA - THE FRENCH EXPERIENCE

The cause of the rare and severe condition of aplastic anaemia is larg ely unknown, although certain drugs have been implicated as possible a etiological factors, mostly through the evidence of case reports. A ca se-control study was conducted in metropolitan France between 1985 and 1988 to investigate aetiological factors in aplastic anaemia. It was conducted in parallel with the establishment of a national register of the incidence of aplastic anaemia, which started in May 1984. The con trols used in the study consisted of 2 hospitalized controls (i.e. pat ients admitted to hospital at the same time as the case) and a neighbo ur control named by the case. All three controls were matched for age and sex, and were interviewed by the same investigator as the case. A total of 147 cases, 287 hospitalized controls and 108 neighbour contro ls were interviewed. An association of varying degrees was noted betwe en aplastic anaemia and the following conditions or treatments: clinic al hepatitis during the past 6 months; history of chronic immune disor der (mainly rheumatoid arthritis); gold salts and D-penicillamine; col chicine and allo-thiopurinol; acetaminophen and salicylates. This surv ey confirmed the vanishing role of previously known toxic agents in th e aetiology of aplastic anaemia. Some differences observed between the results of the present study and those published previously suggest t hat targeted studies on each category of drug according to specific di sease areas should be initiated.