• Aplastic Anemia

    Definition

    Anemia is a low level of healthy red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low the body does not get enough oxygen. This can cause symptoms such as fatigue, pale skin, or irregular heartbeat.
    Aplastic anemia is a type of anemia caused by problems with bone marrow. It can range from mild to severe.
    Location of Active Bone Marrow in an Adult
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    Causes

    Aplastic anemia is believed to be caused by the patient’s immune system attacking the bone marrow. It slows down the production of blood cells. In some cases, aplastic anemia is a temporary side effect of a medication. It can be reversed if exposure to the cause is stopped.

    Risk Factors

    Rick factors that increase your chances of having aplastic anemia include:
    • Exposure to certain environmental toxins such as those found in gasoline, paint, oil and coal emissions, and industrial solvents
    • High dose radiation and chemotherapy treatments
    • Certain viruses
    • Certain medications (eg, antibiotics, some illegal drugs, medications used to treat rheumatoid arthritis )
    • Bone marrow diseases
    • Pregnancy
    The cause of aplastic anemia is sometimes unknown.

    Symptoms

    If you experience any of these symptoms, do not assume it is due to aplastic anemia. These symptoms may be caused by other, less serious health conditions.
    • Fatigue
    • Shortness of breath with activity
    • Weakness
    • Rapid heart rate
    • Pale skin
    • Easy bruising
    • Frequent infections
    • Nosebleeds and bleeding gums
    • Lengthy bleeding from cuts
    • Skin rash
    • Fever
    • Shortened attention span

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests to diagnose aplastic anemia include:
    After you are diagnosed with aplastic anemia, you may need additional tests to determine the cause.
    You will be referred to a blood disorder specialist, a hematologist, or a special treatment center for further evaluation.

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment for aplastic anemia varies according to severity and cause.

    Blood Transfusions

    Blood transfusions provide your body with the blood cells that your bone marrow has stopped producing. This is not a cure. It helps relieve symptoms.

    Immune Suppressing Drugs

    These drugs change or slow your immune system to keep it from damaging your bone marrow cells. This gives your bone marrow time to recover and begin producing blood cells again. The drugs used are antithymocyte globulin (ATG) and cyclosporine. They are sometimes used along with steroids to reduce side effects. This treatment often requires a short stay in the hospital.

    Bone Marrow Transplantation

    The replacement of diseased bone marrow with healthy bone marrow is the best treatment option for some with severe aplastic anemia. You will need a donor whose bone marrow matches your own as closely as possible.

    Other Treatments

    Your aplastic anemia may be mild to moderate. It may also be caused by exposure to radiation, chemicals, or medications. Your doctor may choose to monitor your condition if the cause of the aplastic anemia is stopped. This approach can be enough to restore normal bone marrow function.
    If you are diagnosed with aplastic anemia, follow your doctor's instructions .
    If you are diagnosed with aplastic anemia, follow your doctor's instructions .

    Prevention

    Most cases of aplastic anemia cannot be prevented. Limiting exposure to certain environmental toxins can reduce your risk of developing the disease. Environmental toxins include those found in gasoline, paint, oil and coal emissions, and industrial solvents.

    RESOURCES

    Aplastic Anemia and MDS International Foundation http://www.aplastic.org

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

    Aplastic Anemia and Myelodysplasia Association of Canada http://www.aamac.ca

    The College of Family Physicians of Canada http://www.cfpc.ca

    References

    Ahn M, Choi J, Lee Y, et al. Outcome of adult severe or very severe aplastic anemia treated with immunosuppressive therapy compared with bone marrow transplantation: Multicenter trial. Int J Hematol . 2003;78:133-138.

    Aplastic anemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. updated August 21, 2012. Accessed November 7, 2012.

    Dokal I. Inherited aplastic anemia. Hematol J .2003; 4:3-9.

    Locasciulli A. Acquired aplastic anemia in children: incidence, prognosis, and treatment options. Paediatr Drugs . 2002;4:761-766.

    Loughran T Jr, Storb R. Treatment of aplastic anemia. Hematol Oncol Clin North Am . 1990;4:559-575.

    Young NS. Acquired aplastic anemia. Ann Intern Med .2002;136:534-546.

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