Aplastic anemia is a serious disorder where the bone marrow fails to produce enough red blood cells, white blood cells, and platelets, leading to a condition called pancytopenia. It can be acquired, which is the most common form, or inherited, which is rare. In acquired cases, the immune system may attack the bone marrow, or it may result from certain drugs like chemotherapy agents or antibiotics such as chloramphenicol, toxins like benzene or pesticides, viral infections such as hepatitis,
HIV, EBV, or parvovirus, radiation exposure, or sometimes no identifiable cause. Inherited forms include Fanconi anemia and dyskeratosis congenita.
The symptoms are due to low levels of all blood cells. Low red blood cells cause fatigue, weakness, breathlessness, and pale skin. Low white blood cells make the person prone to frequent or severe infections. Low platelets lead to easy bruising, prolonged bleeding, gum bleeding, or frequent nosebleeds.
Diagnosis starts with a
complete blood count showing reduced levels of all three cell types. A bone marrow biopsy typically shows “empty” marrow without cancerous cells. Additional tests may be done to rule out infections, autoimmune disorders, or genetic causes in younger patients.
Treatment depends on age, severity, and the underlying cause. Supportive care includes blood transfusions for anemia or thrombocytopenia and antibiotics for infections. Immunosuppressive therapy with drugs like antithymocyte globulin, cyclosporine, and sometimes steroids is used if the immune system is attacking the marrow. Growth factors such as eltrombopag can stimulate blood cell production, and G-CSF may be used for white cell support. The only potential curative option is a bone marrow or stem cell transplant, especially in younger patients with a matched donor.
The prognosis has improved significantly with modern therapy. Many patients achieve remission or good long-term outcomes, but if untreated, severe aplastic anemia can lead to life-threatening infections or bleeding complications.
blood transfusion for emergency treatment
bone marrow transplantation is the definitive treatment