Bone-marrow changes in human malaria

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Abstract
A study was made of the bone marrow and peripheral blood of 49 patients suffering from Plasmodium viyax and P. falciparum infections. The majority of acute cases had hypocellular erythroplastic bone marrow. Follow-up studies in 36 cases, after the infection had been controlled, revealed that 34 eventually developed a normal or hypercellular marrow, and all but four showed a rapid increase in the production of erythroid tissue. Forty-four patients were anaemic when first examined. The anaemia progressed for some time after the disappearance of parasitaemia in 15 cases and remained unchanged in 12. The serum indirect bilibrubin was raised in 9 cases only. The absolute and relative increase in the megakaryocyte and leucocytic series, noted at the time of infection, disappeared during the period of recovery. The evidence thus indicates that erythropoiesis is suppressed in malaria. The erythroid depression was commoner in acute cases than in those of longer duration. The degree of depression of erythroid cells during parasitaemia was apparently unrelated to the degree of anaemia induced. There was no relation between the serum concentration of indirect bilirubin (which might indicate active haemolysis) and the degree of anaemia.

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