Aplastic Anemia

Definition
Aplastic anemia is a noncontagious disease which occurs when the bone marrow stops producing blood cells. Bone marrow is the red, spongy, inner part of the bone and is responsible for supplying the body with three types of blood cells: red blood cells which deliver oxygen to all parts of the body, white blood cells which protect the body from germs, and platelets needed for blood to clot. This disease can affect anyone of any age, race, or gender.
Aplastic anemia can be diagnosed as idiopathic, meaning the cause is unknown, but usually environmental factors may be the cause. In very rare cases, aplastic anemia can be hereditary.
The severity of this condition can range from mild to severe. If you suspect you have this condition, contact your doctor immediately.
Location of Active Bone Marrow in an Adult


Causes
Aplastic anemia is believed to be caused by the patient’s own immune system attacking the bone marrow, interfering with the production of blood cells. In some cases, aplastic anemia is a temporary side effect of a medication and can be reversed if exposure to the cause is stopped.
Risk Factors
A risk factor either contributes or causes a disease. The following risk factors can contribute to the development of aplastic anemia:
• 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 such as those used to treat rheumatoid arthritis, antibiotics, and some illegal drugs
• Bone marrow diseases
• Pregnancy
• Unknown causes
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. If you experience any one of them, see your physician.
• Fatigue
• Shortness of breath with exertion
• Weakness
• Rapid heart rate
• Pale skin
• Easy bruising
• Frequent infections
• Nosebleeds and bleeding gums
• Prolonged bleeding from cuts
• Skin rash
• Fever
• Shortened attention span
Diagnosis
Your doctor will ask about your symptoms and medical history and perform a physical exam. Tests to diagnose aplastic anemia include:
• Blood Test–A sample of your blood is taken to determine if you have below normal counts of two or more types of blood cells—red blood cells, white blood cells, or platelets.
• Bone Marrow Biopsy–This procedure allows the doctor to take a small, intact sample of your bone marrow. The sample is examined under a microscope to rule out other blood-related diseases and to determine the quantity and quality of your bone marrow cells. In aplastic anemia, the bone marrow will contain fewer blood cells than normal.
Once diagnosed with aplastic anemia you may need additional tests to determine the underlying cause.
For further evaluation and treatment, you will be referred to a blood disorder specialist, a hematologist, or a special treatment center for aplastic anemia.
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, but instead helps to relieve symptoms.
Immune-suppressing Drugs
These drugs alter or suppress 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 in combination with steroids to lessen the side effects. This treatment often requires brief hospitalization.
Bone Marrow Transplantation
The replacement of diseased bone marrow with healthy bone marrow is the best treatment option for some with severe aplastic anemia. For a successful transplant, the patient needs a donor whose bone marrow matches his or her own as closely as possible.
Other Treatments
If the aplastic anemia is mild to moderate and is caused by exposure to radiation, chemicals, or medications, observation and the immediate discontinuation of the identified cause can be enough to restore normal bone marrow function.
Prevention
Although most cases of aplastic anemia cannot be prevented, limiting exposure to certain environmental toxins such as those found in gasoline, paint, oil and coal emissions, and industrial solvents can reduce the risk of developing the disease.