Spontaneous remission of aplastic anemia: a retrospective analysis

Background and Objectives. Although acquired aplastic anemia (AA) is usuall y a chronic disorder, a small proportion of patients with aplastic anemia h as been reported to recover spontaneously without specific therapy such as allogeneic bone marrow transplantation or immunosuppressive treatment. We a ttempted to determine the rate of spontaneous remission in patients with AA . Design and Methods. We reviewed the medical records of adult patients (n=13 6) who were diagnosed as having aplastic anemia at the Asan Medical Center from 1990 to 2000. The hematologic criteria of spontaneous remission were d efined according to the proposed remission criteria of the SAA Working Part y of the EBMT Results. Eighteen (13%) of 136 patients satisfied the criteria for spontane ous remission at a median of 14 days (range, 4-332) from the diagnosis of a plastic anemia. In fifteen (83%) of 18 patients, spontaneous remission occu rred within 50 days, Spontaneous remission was complete in fourteen patient s (78%). Only two patients relapsed at 208 and 1,857 days after spontaneous remission. Multivariate logistic regression analysis showed that the prese nce of infection at diagnosis (p = 0.017), a drug as an etiology of aplasti c anemia (p = 0.028), and serum albumin level less than 3.4 g/dL (p = 0.005 ) were independent predictive factors for spontaneous remission. Interpretation and Conclusions. Our study confirmed that a minority of pati ents with AA recovered spontaneously. Spontaneous remission was rapid and c omplete in most patients, and relapses were rarely observed. in most cases with spontaneous remission, aplastic anemia might associated with external factors such as a drug or infection. (C) 2001, Ferrata Storti Foundation.