Hematologic effects of acute and chronic alcohol abuse

Alcoholism affects 3 to 10 per cent of the population and costs Americans about $60 billion a year. The disease can be identified in from 19 to 25 per cent of hospital admissions. It is responsible for almost 10 per cent of direct health care costs and more than 200,000 deaths annually. Increased attention to alcoholism has allowed the development of sensitive historic means by which a diagnosis can be established earlier in its natural course. Unfortunately, laboratory abnormalities appear late, long after dependence/addiction is well established. Ethanol is toxic to all organs. Adverse hematopoietic effects result from direct toxicity to the bone marrow and indirectly from other metabolic derangements. Since normal function of the hematopoietic system is dependent on the coordinated interplay of many other systems, it is not surprising that ethanol's effects on the blood may be multiple, complex, and highly variable. This review summarizes current information about the hematologic sequela of alcohol abuse. An introductory overview of ethanol-related metabolic events is followed by discussions of specific disorders of erythrocytes, leukocytes, platelets, and the immune apparatus.