To the Editor.—
The recent article by Mills1 on sickle cell disease repeatedly uses the phrase "aplastic crisis." This frequently used phrase is a misnomer since only erythroid hypoplasia occurs. The author himself acknowledges that "the reticulocyte count is very low, usually with no accompanying neutropenia or thrombocytopenia," and the bone marrow aspirate shows "marked hypoplasia of the erythroid cell line" with preservation of other marrow precursors. An erythroid aplastic crisis in sickle cell disease, mostly reversible with proper treatment, should not be confused with aplastic anemia. The latter is a very serious disorder associated with profound pancytopenia and an often fatal outcome despite the best treatment efforts.
Rosner F. Erythroid Hypoplasia in Sickle Cell Disease. JAMA. 1986;255(10):1291. doi:10.1001/jama.1986.03370100085020