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
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.
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 (eg, antibiotics, some illegal drugs, medications used to treat rheumatoid arthritis]]> )
- Bone marrow diseases
- Unknown causes
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.
- Shortness of breath with exertion
- Rapid heart rate
- Pale skin
- Easy bruising
- Frequent infections
- Nosebleeds]]> and bleeding gums
- Prolonged bleeding from cuts
- Skin rash
- Shortened attention span
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.
Talk with your doctor about the best treatment plan for you. Treatment for aplastic anemia varies according to severity and cause.
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, you need a donor whose bone marrow matches your own as closely as possible.
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.
If you are diagnosed with aplastic anemia, follow your doctor's instructions.
Aplastic Anemia and MDS International Foundation
National Heart, Lung, and Blood Institute
Aplastic Anemia and Myelodysplasia
Association of Canada
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.
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.
Last reviewed November 2008 by ]]>Igor Puzanov, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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