Effect of Cholinesterase-containing Globulin Fraction of Human Plasma in Macrocytic Anemia

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Abstract
Three patients with macrocytic anemia were given infusions of IV-6 human plasma fraction, containing 500 Alles and Hawes units of serum cholinesterase (ChEase)/g. There was a small transitory rise in ChEase which subsided and was followed by a more marked rise confined to the erythrocyte phase occurring in 2 patients, and which was of a much greater extent than could be explained on the basis of dosage. When the secondary rise subsided there was a return to normal in the pre- viously elevated icteric index and a reticulocytosis. The hypothesis that macrocytic anemia is the result of a cholinergic "brake" on erythropoiesis is probably true. A child with malignant lymphoblastosis receiving the IV-6 fraction, showed transient improvement but no rise in erythrocyte ChEase or reticulocytosis. This suggests that the gravity of the malignant estrogenic blood dyscrasias is conditioned by the degree of loss of ability of the erythropoietic tissues to form ChEase.