Lead and haemoglobin synthesis: a review

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Abstract
It has been known for many years that lead poisoning is associated with both abnormal haemoglobinization of the red cell and red cell production. Thus Gould, Kullman and Shecket noted in 1937 that the treatment of cancer patients with lead resulted over several weeks in a progressive anaemia, reticulocytosis and erythroblastosis. Basophilic stippling of red cells was a prominent feature. Recently it has been realized that lead exposure does not invariably lead to anaemia in the adult, although in children it may be marked (Albahary, Guillaume and Martin, 1965; Boyett and Butterworth, 1962; Hutchinson and Stark, 1961; Watson, Deckers and Lichtman, 1962). The bone marrow morphology shows normoblastic hyperplasia and the presence of abnormal ringed sideroblasts, the last of which indicates that the controlled synthesis of haemoglobin within the cell is abnormal. This has now been confirmed by the finding that the synthesis of both globin and haem were inhibited by inorganic lead in vitro.