Aplastic anemia is a rare but serious blood disorder. In this disorder, bone marrow doesn't make enough new blood cells. Causes include
- Being exposed to toxic substances, such as pesticides, arsenic, and benzene
- Radiation therapy and chemotherapy for cancer
- Certain medicines
- Infections such as hepatitis, Epstein-Barr virus, or HIV
- Autoimmune disorders
- Certain inherited conditions
In many people, the cause is unknown.
Aplastic anemia is a disorder in which the bone marrow fails to make enough blood cells. The bone marrow is the soft, inner part of bones where the 3 types of blood cells are made:
- Red blood cells, which carry oxygen to the tissues from the lungs
- White blood cells, which fight infection
- Platelets, which seal damaged blood vessels to prevent bleeding
These cells are made by blood-forming stem cells in the bone marrow. In aplastic anemia, the stem cells are damaged and there are very few of them. As a result, too few blood cells are produced. In most cases of aplastic anemia, all 3 types of blood cells are low (which is called pancytopenia). Rarely, just one of the cell lines, such as red cells, white cells, or platelets, is abnormal.
Aplastic anemia is not a type of cancer but may be associated with certain cancers (especially those affecting the bone marrow, such as leukemia) or cancer treatments. A small number of patients with aplastic anemia may develop leukemia.
Aplastic anemia can be inherited or acquired. Acquired aplastic anemia is much more common than the inherited type
Doctors diagnose aplastic anemia based on medical and family histories, a physical exam, and test results. Once doctor knows the cause and severity of the condition, he or she can create a treatment plan. Treatments include blood transfusions, blood and marrow stem cell transplants, and immunosuppressant medicines.
How Can Aplastic Anemia be managed?
Treatments for aplastic anemia include blood transfusions, blood and marrow stem cell transplants, and Immunosuppressant Medicines. These treatments can prevent or limit complications, relieve symptoms, and improve quality of life.
Blood and marrow stem cell transplants may cure the disorder in some people who are eligible for a transplant. Removing a known cause of aplastic anemia, such as exposure to a toxin, also may cure the condition.
Blood transfusions can help keep blood cell counts at acceptable levels. A blood transfusion is a common procedure in which blood is given to patient through an intravenous (IV) line in one of blood vessels.
Transfusions require careful matching of donated blood with the recipient's blood.
Blood transfusions help relieve the symptoms of aplastic anemia, but they're not a permanent treatment.
Blood and Marrow Stem Cell Transplants
A blood and marrow stem cell transplant replaces damaged stem cells with healthy ones from another person (a donor).
During the transplant, which is like a blood transfusion, patient get donated stem cells through a tube placed in a vein in chest. Once the stem cells are in body, they travel to bone marrow and begin making new blood cells.
Blood and marrow stem cell transplants may cure aplastic anemia in people who can have this type of treatment. The transplant works best in children and young adults with severe aplastic anemia who are in good health and who have matched donors.
Older people may be less able to handle the treatments needed to prepare the body for the transplant. They're also more likely to have complications after the transplant.
These are medicines To Suppress the Immune System
Research suggests that aplastic anemia may sometimes occur because the body's immune system attacks its own cells by mistake. For this reason, doctor may prescribe medicines to suppress your immune system.
These medicines allow bone marrow to start making blood cells again. They also may help to avoid the need for blood transfusions.
Medicines that suppress the immune system don't cure aplastic anemia. However, they can relieve its symptoms and reduce complications. These medicines often are used for people who can't have blood and marrow stem cell transplants or who are waiting for transplants.
Three medicines—often given together—can suppress the body's immune system. They are antithymocyte globulin (ATG)/Thymogam at a dose of 30-40 mg/kg/day for 4-5 days, cyclosporine, and methylprednisolone.