HEMOGLOBIN PRODUCTION FACTORS IN THE HUMAN LIVER : III. ANEMIAS—PRIMARY, APLASTIC AND SECONDARY—LEUKEMIAS

Biological assay of the human liver in various types of anemia shows conspicuous differences in the concentration of hemoglobin producing factors. Pernicious anemia shows very high values and the liver in untreated cases may show maximal storage of the hemoglobin producing factors. Liver therapy reduces this store as the missing factor is supplied and new hemoglobin and red cells can be turned out by the marrow. Aplastic anemia likewise shows high concentration of hemoglobin producing factors as there is no outlet for this material through the red marrow. Secondary anemia due to loss of blood will show low normal values but even long standing severe anemia will not seriously deplete this store of hemoglobin producing factors in the liver. Secondary anemia due to blood destruction within the body shows higher values and some excess store of hemoglobin producing factors and iron. Leukemia gives a biological assay like secondary anemia due to blood loss and always presents definite anemia. Iron analyses show conspicuous differences and iron concentration within the liver parenchyma does not in any way parallel the concentration of hemoglobin producing factors. The highest values for iron concentration are found in aplastic anemia (70 mg. per cent)— high values in pernicious anemia (51 mg. per cent)—normal values in leukemia (13 mg. per cent)—and low values in anemia due to loss of blood (5.3 mg. per cent). These findings should aid in a more complete understanding of the pathogenesis and internal metabolism of various anemias.