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Causes of macrocytic anemia among 628 patients: mean corpuscular volumes of 114 and 130 fL as critical markers for categorization

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Abstract

There have been no studies on the distribution of causes of macrocytic anemia with respect to mean corpuscular volume (MCV) cutoff values. We retrospectively investigated the causes of macrocytic anemia (MCV ≥100 fL) among 628 patients who visited the outpatient hematology clinic in Tohoku University Hospital. To ensure data validity, we also analyzed data from 307 patients in eight other hospitals in the Tohoku district. The leading causes of macrocytic anemia (number of patients, %) were myelodysplastic syndromes (121, 19.3 %), suspected bone marrow failure syndromes (BMF; 74, 11.8 %), aplastic anemia (51, 8.1 %), plasma cell dyscrasia (45, 7.2 %), and vitamin B12 deficiency (40, 6.4 %) in Tohoku University Hospital. We made three primary findings as follows. First, the most common cause of macrocytic anemia is BMF. Second, lymphoid and solid malignancies are also common causes of macrocytosis. Third, macrocytic anemia may be classified into three groups: Group 1 (megaloblastic anemia and medications), which can exceed MCV 130 fL; Group 2 (alcoholism/liver disease, BMF, myeloid malignancy, and hemolytic anemia), which can exceed MCV 114 fL; and Group 3 (lymphoid malignancy, chronic renal failure, hypothyroidism, and solid tumors), which does not exceed MCV 114 fL. These conclusions were supported by the results from eight other hospitals.

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Acknowledgments

The authors thank the Tohoku Hematology Forum (THF), Tohoku Hematology Expert Meeting (NPO-THEMe) for supporting this study, and all physicians for their participation in this study.

Author information

Authors and Affiliations

  1. Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan

    Natsuko Takahashi, Junichi Kameoka & Hideo Harigae

  2. Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan

    Naoto Takahashi & Kenichi Sawada

  3. Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan

    Yoshiko Tamai

  4. Department of Hematology/Oncology, Internal Medicine, Iwate Medical University, Morioka, Japan

    Kazunori Murai, Shigeki Ito & Yoji Ishida

  5. Department of Hematology, Iwate Prefectural Central Hospital, Morioka, Japan

    Kazunori Murai

  6. Department of Hematology, Yamagata Prefectural Central Hospital, Yamagata, Japan

    Riko Honma

  7. Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan

    Hideyoshi Noji

  8. Department of Hematology, Sendai Medical Center, Sendai, Japan

    Hisayuki Yokoyama

  9. Department of Hematology, Miyagi Cancer Center, Natori, Japan

    Yasuo Tomiya

  10. Department of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Faculty of Medicine, Yamagata University, Yamagata, Japan

    Yuichi Kato & Kenichi Ishizawa

Authors
  1. Natsuko Takahashi
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  2. Junichi Kameoka
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  3. Naoto Takahashi
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  4. Yoshiko Tamai
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  5. Kazunori Murai
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  6. Riko Honma
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  7. Hideyoshi Noji
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  8. Hisayuki Yokoyama
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  9. Yasuo Tomiya
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  10. Yuichi Kato
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  11. Kenichi Ishizawa
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  12. Shigeki Ito
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  13. Yoji Ishida
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  14. Kenichi Sawada
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  15. Hideo Harigae
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Corresponding author

Correspondence to Junichi Kameoka.

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The authors state that they have no Conflict of Interest (COI).

Additional information

All authors belong to the study group of Tohoku Hematology Forum (THF).

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Takahashi, N., Kameoka, J., Takahashi, N. et al. Causes of macrocytic anemia among 628 patients: mean corpuscular volumes of 114 and 130 fL as critical markers for categorization. Int J Hematol 104, 344–357 (2016). https://doi.org/10.1007/s12185-016-2043-x

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  • DOI: https://doi.org/10.1007/s12185-016-2043-x

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