Aplastic anemia: Symptoms, Causes, Diagnosis, Treatment & Prevention

 

Your body can develop aplastic anemia if it stops producing enough new red blood cells. You become exhausted from the disease and become more vulnerable to infections and uncontrollable bleeding.

Aplastic anemia is a rare and dangerous illness that can strike at any age. It may start slowly and get worse over time, or it may happen quickly. It could be mild or severe.
Medication, blood transfusions, or stem cell transplantation—also referred to as a bone marrow transplant—may be used as treatments for aplastic anemia.

 It occurs when the bone marrow is damaged to the point where it cannot produce enough new platelets and blood cells. If left untreated, aplastic anemia poses a life-threatening risk. Although medical professionals can treat aplastic anemia, a stem cell transplant is the only cure available.

Also Read: Vitamin deficiency anemia: Symptoms, Causes, Risk factors, Diagnosis, Treatment & Prevention

What is Aplastic anemia?

Aplastic anemia is a rare yet serious blood condition. It occurs when your bone marrow is cannot produce enough platelets and blood cells. Aplastic anemia patients are more vulnerable to life-threatening infections, hemorrhaging, heart problems, and other complications. The only known cure for aplastic anemia is a stem cell transplant, however, there are therapies to control its symptoms.

Aplastic anemia may appear quickly or develop slowly. It might be life-threatening if your blood count falls too low.

Aplastic anemia can strike anyone, but it tends to strike more frequently in late adolescence or early adulthood and in older adults (over 60).

 Symptoms:

Anemia aplastic may not exhibit any symptoms. Symptoms that may be present include:

• Fatigued

• Breathlessness

• Rapid or irregular heart rate

• Pale skin

• Frequent infections

• Inexplicable or simple bruises

• Gum bleeding and nosebleeds

• Prolonged bleeding following wounds

• Sunburn Feeling dizzy

• Fever 

• Headaches

Aplastic anemia may develop into a chronic condition or be transient. It may be very serious or even fatal.

Causes:

Red, white, and platelet blood cells are produced by bone marrow stem cells. Damage is done to stem cells in aplastic anemia. Consequently, the bone marrow is either hypoplastic—containing few blood cells—or empty (aplastic).

The most common cause of aplastic anemia is an immune system attack on bone marrow stem cells. Other elements that can harm bone marrow and impact the generation of red blood cells are as follows:

• Chemotherapy and radiation therapy. These anti-cancer treatments destroy cancer cells, but they can harm good cells as well, such as bone marrow stem cells. One transient side effect of these treatments may be aplastic anemia.

• Exposure to toxic chemicals. Aplastic anemia has been connected to toxic chemicals, including some found in insecticides and pesticides, as well as benzene, an element in gasoline. If you stay away from the chemicals that caused your disease repeatedly, your kind of anemia might get well.

• Usage of specific medications. Aplastic anemia can be brought on by certain drugs, including certain antibiotics and those used to treat rheumatoid arthritis.

• Autoimmune disorder. Your bone marrow may contain stem cells if you have an autoimmune disorders, which is characterized by an immune system attack on healthy cells.

• An infection caused by a virus. Aplastic anemia can arise as a result of bone marrow-related viral infections. Aplastic anemia has been associated with several viruses, including HIV, CMV, parvovirus B19, Epstein-Barr, and hepatitis.

• Pregnancy. During pregnancy, your immune system may target your bone marrow.

• Unknown factors. Physicians frequently are unable to determine the cause of aplastic anemia (idiopathic aplastic anemia).

Risk factors:

Rare is aplastic anemia. Among the variables that may raise risk are:

• Chemotherapy or high-dose radiation treatment for cancer

• Exposure to toxic chemicals

• Using some prescribed drugs, such as gold compounds to treat rheumatoid arthritis and chloramphenicol to treat bacterial illnesses

• Serious infections, autoimmune illnesses, and certain blood diseases

• Rarely, pregnancy

Diagnosis:

Testing for aplastic anemia can be done in the following ways:

• Biopsy of the bone marrow. A tiny sample of bone marrow is taken by a doctor using a needle from a big bone in your body, like your hipbone. A microscope is used to look at the sample to rule out other blood-related disorders. Bone marrow in aplastic anemia has a lower- than -usual concentration of blood cells. The diagnosis of aplastic anemia must be confirmed by bone marrow biopsy.

• Differential and complete blood count (CBC) combined. This counts and analyzes all five types of white blood cells in your blood.

• Smear of peripheral blood. Under a microscope, medical pathologists study your platelets and blood cells.

• Count of reticulocytes. This test measures the number of reticulocytes or immature red blood cells.

Complications:

Aplastic anemia people may experience the following complications, some of which could be fatal:

• Anemia

• Severe infections

• Excessive loss of blood

• Heart failure or an arrhythmia

• Syndrome myelodysplastic

In what ways is aplastic anemia treated?

Your situation will determine the course of treatment. Aplastic anemia, for instance, can occur in certain patients getting treatment for autoimmune diseases or cancer. In that instance, physicians might be able to treat aplastic anemia by changing the course of treatment.

Providers may diagnose you with moderate aplastic anemia if testing reveals that your blood cell counts are lower than normal and you are symptom-free. If it appears that your illness is growing worse, your provider can then advise keeping an eye on your general health and blood levels so they can take immediate action.

More severe cases of aplastic anemia can be treated with the following:

• Immunosuppressive medicines. These medications suppress your immune system, stopping it from attacking your stem cells. Aplastic anemia is treated with immunosuppressants such as cyclosporine (Sandimmune®) and antithymocyte globulin injection (Atgam®).

• Transfusions of blood. Platelets and red blood cells are substituted via transfusions. Although they don't treat aplastic anemia, transfusions can lessen some of its symptoms.

• Antibiotics. The risk of bacterial infection is elevated by aplastic anemia. Infections can be treated using antibiotics.

• Transplanting stem cells from another person. Your bone marrow's damaged stem cells are replaced by healthy stem cells from donated bone marrow or blood by the providers.

Side effects of the medication:

The following side effects vary with treatment:

• One side effect of allogeneic stem cell transplantation is graft-versus-host disease.

• Immunosuppressive medication-induced increased risk of infection.

• Blood transfusions can cause hemochromatosis or iron overload.

Prevention:

For the majority of cases, aplastic anemia has no known cure. Your chance of contracting the illness may be reduced if you stay away from organic solvents, paint removers, pesticides, herbicides, and other toxic chemicals.

References:

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• Aplastic anemia. Aplastic Anemia and MDS International Foundation. https://www.aamds.org/diseases/aplastic-anemia. Accessed Nov. 16, 2019.

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• National Heart, Lung, and Blood Institute (U.S.). Aplastic Anemia (https://www.nhlbi.nih.gov/health-topics/aplastic-anemia). Last updated March 24, 2022. Accessed 6/22/2023.