Aplastic Anemia

Aplastic anemia is a condition in which the bone marrow fails to produce blood cells.

What is going on in the body?

The bone marrow contains special cells known as stem cells. Stem cells are like infant cells. They may develop into red blood cells, white blood cells, and platelets. Red blood cells carry oxygen throughout the body. White blood cells fight infection. Platelets control bleeding by forming blood clots in certain situations. Blood cells have a limited life, so new ones are made constantly.

Certain conditions can damage stem cells or change their environment. The stem cells stop making blood cells. The bone marrow fills up with fat, instead of developing blood cells. The low level of red blood cells, white blood cells, and platelets in the body is known as aplastic anemia.

What are the causes and risks of the condition?

In 50% of the people with aplastic anemia, the cause is unknown. In other cases, the anemia may be caused by one of the following factors:

airplane glue

blood disorders

chemicals, such as benzene and pesticides

chemotherapy

drugs, such as chloramphenicol

inherited or genetic causes, which may be present at birth

pregnancy

radiation therapy

viruses such as herpes, hepatitis C, and HIV

Some experts believe that aplastic anemia is an autoimmune disorder, a condition in which the body produces antibodies against its own blood cells.

What are the signs and symptoms of the condition?

A person with aplastic anemia may have the following symptoms:

fatigue

pale skin

rapid heartbeat

weakness

How is the condition diagnosed?

Diagnosis of aplastic anemia begins with a medical history and physical exam. The healthcare provider may order a complete blood count, or CBC, with a differential. This blood test measures the level of red blood cells, white blood cells, and platelets.

If blood tests are abnormal, the provider may order a bone marrow biopsy. This test involves inserting a special needle into the hip bone. A sample is taken from the bone marrow. It is examined under a microscope to check for the number of each kind of blood cell.

What can be done to prevent the condition?

Aplastic anemia is not always preventable. Some cases may be prevented by limiting exposure to chemicals, such as pesticides. Effective treatment of viral diseases may lower the risk for anemia.

What are the long-term effects of the disease?

Aplastic anemia is a life-threatening emergency. In many cases, it is fatal. If treatment is successful, the individual will have a lengthy recovery period while the body gets back to normal.

What are the risks to others?

Aplastic anemia is not contagious and poses no risk to others.

What are the treatments for the disease?

Aplastic anemia is life- threatening. Initial treatment often includes the following:

antibiotics to prevent infection

blood transfusions to replace red blood cells

isolation to keep the person from contacting an infection

reduced activity to help prevent weakness

Other treatments may be ordered, depending on the cause of the aplastic anemia. These treatments include the following:

antithymocyte globulin, or ATG, and antilymphocyte globulin, or ALT, which reduce the body’s ability to attack its own cells

colony-stimulating factors, or CSFs, which stimulate the production of some blood cells

cyclosporine combined with androgens, which may stimulate the production of blood cells

interleukin-3, or IL-3, which stimulates blood cell production

matched stem cell transfusions, which replace damaged stem cells

Bone marrow transplant is an effective treatment for some people with aplastic anemia. More than half of the good candidates for bone marrow transplant are cured. People are good candidates if they meet the following criteria.

They are younger than 40 years of age.

They had good health prior to the transplant.

They have a matched donor, such as a family member.

What are the side effects of the treatments?

Medications used to treat aplastic anemia may increase the person’s risk for infection. Some may cause allergic reactions. A bone marrow transplant may cause bleeding, infection, or allergic reaction to anesthesia.

What happens after treatment for the disease?

Until blood cell counts return to normal, someone who has aplastic anemia is at risk for infection, bleeding, and other complications. It’s important to avoid risk factors, including:

activities that cause a rapid heartbeat, chest pain, or shortness of breath

activities that have a high risk of injury, such as football and skiing

excess exercise

exposure to contagious diseases

high altitudes

unnecessary dental work or surgery

How is the disease monitored?

The person with aplastic anemia will have regular visits with the healthcare provider. Repeated blood tests may be ordered to test for the number of red blood cells, white blood cells, and platelets. Any new or worsening symptoms should be reported to the provider.