What is Aplastic Anemia?
Aplastic Anemia is a pathological condition in which the body does not produce enough red blood cells that is required for normal functioning of the body which results in a variety of symptoms including severe persistent fatigue and making an individual prone to several infections. Aplastic Anemia is quite rare but potentially a serious medical condition. This can develop at any age. It may develop suddenly or may gradually develop over a period of time and start to worsen with time.
Treatment for Aplastic Anemia includes use of certain medications along with periodic blood transfusions. Stem cell transplant has also shown to be effective in treating Aplastic Anemia. This disease usually develops due to some sort of damage to the bone marrow. Bone marrow is a material in the bones which is responsible for making new red blood cells. Due to this damage there is reduced production or even in some cases complete absence of production of red blood cells causing Aplastic Anemia.
What Causes Aplastic Anemia?
As stated, Aplastic Anemia develops due to some sort of damage to the bone marrow which is a red material located inside the bones which is responsible for making new red blood cells. The bone marrow also has stem cells which are responsible for making new cells and plays an important role in making of new red blood cells. In Aplastic Anemia there are very few blood cells in the bone marrow which is not sufficient to carry out all the bodily functions normally. Some of the factors which can damage the bone marrow and affect the production of red blood cells are:
Radiation and Chemotherapy Treatments: These therapies not only kill the cancer cells but they also tend to damage healthy cells of which the cells in the bone marrow are one and hence such therapies may lead to Aplastic Anemia.
Toxic Exposure: Repetitive exposure to toxins like pesticides and insecticides may also damage the bone marrow and result in Aplastic Anemia.
Medications: There are certain classes of medications such as those used to treat immune disorders like rheumatoid arthritis have shown to cause Aplastic Anemia
Autoimmune Disorders: There are certain autoimmune conditions which are also responsible for damaging the bone marrow and thus cause Aplastic Anemia.
Viral Infections: Certain viral infections which affect the bone marrow may also predispose an individual towards developing Aplastic Anemia. These infections include hepatitis, Epstein-Barr, cytomegalovirus, and HIV
Pregnancy: Pregnancy is also one of the causes for Aplastic Anemia, as during pregnancy the immune system of the body may attack the healthy tissues and cells of the body causing conditions like Aplastic Anemia.
What are the Symptoms of Aplastic Anemia?
Some of the symptoms of Aplastic Anemia are:
- Persistent fatigue and lethargy
- Difficulty breathing with any strenuous activity
- Irregular heart rate
- Pale skin
- Frequent infections
- Easy bruising
- Bleeding gums
- Skin rash
How is Aplastic Anemia Diagnosed?
In order to definitively diagnose Aplastic Anemia, the physician may recommend the following tests after ruling out other conditions that may be causing the symptoms. These tests are:
Blood Draws: These will be done to check the levels of the red blood cells, white blood cells, and platelets. If the levels of all these three very are low then it virtually confirms the diagnosis of Aplastic Anemia.
Bone Marrow Biopsy: This is confirmatory test to diagnose Aplastic Anemia. A bone marrow biopsy is done by taking out a sample of the bone marrow and sending it for analysis. In cases of aplastic anemia, there will be very few blood cells than what the normal count is.
These tests will confirmatively diagnose Aplastic Anemia.
How is Aplastic Anemia Treated?
For mild cases of Aplastic Anemia, observation is the only recommended treatment looking for any worsening of the condition with serial blood tests and bone marrow biopsies. If Aplastic Anemia is more serious in an individual then the individual can be treated with blood transfusions and medications. For severe cases of Aplastic Anemia, the most preferred treatment is bone marrow transplantation. A severe case of Aplastic Anemia is potentially life threatening and requires immediate intervention.
Blood Transfusions: This mode of treatment is done for moderate cases of Aplastic Anemia. This is also done to relieve some of the symptoms of Aplastic Anemia. A blood transfusion may include transfusion of red blood cells and platelets. An individual can receive any number of transfusions but it has been seen that multiple transfusions increase the risk for complications, as the iron present in the transfused blood may accumulate in the body and cause organ damage. Another possible complication is that the body may develop antibodies to the transfused blood and thus the new blood that has been transfused may no longer be effective in relieving the symptoms of Aplastic Anemia.
Stem Cell Transplant: This form of treatment has shown a great deal of promise in treating Aplastic Anemia. This is usually done on individuals with severe case of Aplastic Anemia. In this procedure stem cell from a healthy donor is transplanted into the patient’s bone marrow such that the bone marrow starts to produce healthy cells and thus treat Aplastic Anemia. The mode of transplantation is usually intravenously infusing the healthy stem cells into the patient which slowly find their way into the bone marrow. This method carries its own inherent risks like the body may completely reject the bone marrow leading to serious complications.
Immunosuppressants: This treatment can be used for individuals who have Aplastic Anemia due to autoimmune disorders and those who are not candidate for stem cell transplant. Some of the medications used for Aplastic Anemia are cyclosporine and Thymoglobulin.
Bone Marrow Stimulants: There are certain medications which stimulate the bone marrow in producing healthy red blood cells and thus treat Aplastic Anemia. These drugs are Leukine, Neupogen, and Epogen or Procrit.
If Aplastic Anemia is caused due to pregnancy then the only mode for treatment for pregnant females is blood transfusions but in majority of the cases Aplastic Anemia improves in women once the pregnancy ends.
What is the Prognosis of Aplastic Anemia?
If left untreated Aplastic Anemia can prove to be fatal. Bone marrow transplant has been very successful in the younger population and can help them lead normal lives despite having a condition like Aplastic Anemia.
- Mayo Clinic. (2023). Aplastic anemia. https://www.mayoclinic.org/diseases-conditions/aplastic-anemia/symptoms-causes/syc-20355078
- National Heart, Lung, and Blood Institute. (2021). Aplastic Anemia. https://www.nhlbi.nih.gov/health-topics/aplastic-anemia
- Johns Hopkins Medicine. (2022). Aplastic Anemia. https://www.hopkinsmedicine.org/health/conditions-and-diseases/aplastic-anemia
- Merck Manual. (2021). Aplastic Anemia. https://www.merckmanuals.com/home/blood-disorders/anemia/aplastic-anemia
- MedlinePlus. (2022). Aplastic Anemia. https://medlineplus.gov/aplasticanemia.html