To investigate the hematological changes of patients with acquired immunedeficiency syndrome (AIDS) and to explore the influencing factors.

Total of 122 patients with AIDS treated in our hospital from January 2013 to December 2014 were collected. The clinical materials, including the results of bone marrow smears and peripheral blood indexes, HIV RNA viral roads and T cell subgroups were analyzed, respectively. All the hematological indexes were compared.

Among the 122 cases with AIDS, 112 patients (91.80%) were with abnormal peripheral blood, among whom, 47 patients (38.52%) with leukocytopenia, 102 patients (83.61%) with lymphocyte reduction, 89 patients (72.95%) with hemoglobin reduction, 40 patients (32.79%) with thrombocytopenia. The results of bone marrow smears showed that 57 patients (46.72%) were with reduced hyperplasia of the nucleated cells, 92 patients (75.41%) with reduced hyperplasia of the megakaryocytes. Megakaryocytes were hardly seen among patients with AIDS. Furthermore, 90 cases (73.78%) were with lower red blood cell ratio. In contrast, the granulocyte ratio was increased in 79 cases (64.76%). As for bone marrow cell morphology, there was no significant abnormality, except for infectious bone marrow signs, increased and enlarged cytoplasmic granules in granulocyte, bubbles and tissue cells. In patients with CD4⁺ T cells < 10/μl, bone marrow smears showed 8 cases with hemophagocytic phenomenon, 4 cases with Penicillium marneffei infection, 1 case with Histoplasma infection, and 1 case with toxoplasma infection. Among the 6 patients with cells of unknown classification, 1 case was diagnosed as lymphoma cells by histopathological biopsy and immunohistochemistry, 1 case as possibly lymphoma renal metastases as indicated by PET-CT result, 1 case with systemic lymph node enlargement as acute leukemia through morphology and immunological classification. The levels of CD4⁺ T cell hyperplasia of bone marrow nucleated cells of 51-200/μl group and 0-50/μl group were significantly higher than that of 201-500/μl group (both P < 0.05).

Patients with AIDS were easily to be afflicted by abnormal peripheral blood, peripheral blood was associated with whether HIV RNA load or antiviral therapy, moreover, the hyperplasia degree of the bone marrow was found to be reduced with the reduction of both the CD4⁺ T cell count and immunological functions, AIDS patients with delined immune function were easily complicated with blood system infection. Peripheral blood and bone marrow method was simple, quick and could reflect bone marrow hematopoietic function intuitively, and find fungi and parasitic infection and tumor cells timely, and had important clinical significance to complications diagnosis of patients with AIDS, timely reminder to strengthen the primary prevention of opportunistic infections.