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 RBCs are low, the body does not get enough oxygen.

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    TOP

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    TOP

Factors that may 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 such as antibiotics, some illegal drugs, and medications used to treat rheumatoid arthritis
  • Bone marrow diseases
  • Pregnancy

The cause of aplastic anemia is sometimes unknown.

Symptoms    TOP

Symptoms of aplastic anemia include:

  • Fatigue
  • Shortness of breath with activity
  • Weakness
  • Rapid heart rate
  • Pale skin
  • Easy bruising
  • Nosebleeds and bleeding gums
  • Lengthy bleeding from cuts
  • Skin rash
  • Fever
  • Shortened attention span

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

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    TOP

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 Medication

These medications 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. These medications are sometimes used along with steroids to reduce side effects. This treatment often requires a short stay in the hospital.

Bone Marrow Transplantation    TOP

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    TOP

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.

Prevention    TOP

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:
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Updated June 6, 2014. Accessed August 21, 2014.
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 August 2014 by Marcin Chwistek, MD
Last Updated: 8/21/2014