HEMATOLOGICAL FINDINGS OF SULPHUR MUSTARD POISONING IN IRANIAN COMBATANTS

Sulphur mustard (SM) is an alkylating agent that was first used as a chemical warfare agent during the First World War in 1917. SM is readily absorbed from the skin, respiratory and gastrointestinal tract and is distributed to several organs. SM may act rapidly and persistently upon DNA replicating mechanism of the individual cells during mitosis particularly in the hematopoietic system. Of 233 patients with SM poisoning, hematological investigations were performed in 213 of them. Mild changes were observed in red blood cells and its indices. Initial leukocytosis (> llxl09/L) was observed in 7.2% and leucopenia (‹4x 109/L) in 3.8% of the patients. Marked lymphopenia, neutrocytosis and eosinopenia (‹2%) were found in 36%,38%, and 25% of the patients, respectively. Bone marrow biopsy in 3 fatal cases revealed marked hypocellularity and dyserythropoietic changes. Apart from the respiratory complications, mortality from SM poisoning is mainly due to bone marrow failure.