RAPHAEL ISAACS, M.A., M.D., F.A.C.P.; RALPH W. TRIMMER, M.D., F.A.C.P.
The use of "anti-folic acid" preparations in the treatment of leukemia, as described by Farber, Diamond, Mercer, Sylvester and Wolf,1 has made possible the study of the blood of patients with induced "folic acid deficiency." As folic acid appears to stimulate the maturation of "proerythroblasts" (megaloblasts in pernicious anemia), the absence of this substance should be associated with a delay in the maturation of these cells. Since the red blood cells develop their "size," at this stage, they become larger if delayed too long at this period.
The following case of myeloblastic leukemia illustrates the development of macrocytosis and multilobed
ISAACS R, TRIMMER RW. BLOOD CELL CHANGES IN LEUKEMIA DURING AMINOPTERIN THERAPY1. Ann Intern Med. ;35:236–239. doi: 10.7326/0003-4819-35-1-236
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Published: Ann Intern Med. 1951;35(1):236-239.
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