Prospective study of aplastic anaemia should give definitive answer

doi:10.1136/bmj.311.7002.451a

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E C Gordon-Smith,
J C W Marsh,
C G Geary

Consultant haematologist Manchester Royal Infirmary, Manchester M139WL
Professor of haematology Honorary consultant haematologist St George's Hospital Medical School, London SW170RE

EDITOR,--We disagree with Marie Doona and J Bernard Walsh's conclusions and recommendations relating to chloramphenicol eye drops and aplastic anaemia.1 Many drugs have been implicated as causing aplastic anaemia, but for most the evidence is weak, and no in vitro tests are available to prove causation. Furthermore, an apparent association may not mean causality: the exposure may have been a response to the early features of aplastic anaemia itself.

An association between use of chloramphenicol and the development of aplastic anaemia was predicted because of the drug's structure, and many reports appeared in …