Aplastic anemia What we need to know

27.02.2024

Aplastic anemia is a rare and very serious blood disorder. It is caused by damage to the bone marrow, which inhibits the synthesis of blood-forming elements - erythrocytes, leukocytes and platelets. When diagnosed with aplastic anemia, the risk of developing various infections, bleeding, heart diseases and other complications is high. Without treatment, aplastic anemia causes deep disorders in organ systems and ends in death.

Table of Contents

Aplastic anemia develops at any age, but is more common in people aged 15-25 years and older than 60 years. The frequency of the disease is on average 2-7 cases per million population.

Symptoms

Symptoms of aplastic anemia mainly develop slowly, although in rare cases the clinical picture may develop quickly:

Frequent and prolonged viral infections
General weakness
Propensity to bleeding and bruising
Pale skin
Dizziness
headache
Fever

Sometimes the symptoms of aplastic anemia are masked by symptoms of other diseases, which may go unnoticed and aggravate the condition.

reasons

The causes of the development of the disease are not completely clear, however, it is mainly associated with autoimmune damage to the bone marrow. Under certain circumstances (some congenital conditions, medications, exposure to carcinogenic factors, etc.), the immune system begins to fight against stem cells in the bone marrow, which disrupts the process of blood cell formation.

Diseases that increase the risk of aplastic anemia:

Autoimmune diseases – lupus erythematosus and other autoimmune diseases
Viral infections such as Epstein-Barr virus, cytomegalovirus, parvovirus B19, and human immunodeficiency virus
Paroxysmal nocturnal hemoglobinuria - acquired pathology, when erythrocytes are rapidly destroyed
Pregnancy

Hereditary diseases

There is an opinion that the development of aplastic anemia is related to congenital pathologies of the bone marrow. Hereditary pathologies are:

Fanconi anemia
Schwachman-Diamond syndrome
Congenital dyskeratosis
Diamond-Blackfan anemia
Pearson syndrome

Medications

Remedies for autoimmune conditions
Radiation and chemotherapy in the treatment of cancer

Long-term exposure to carcinogens such as arsenic and benzene increases the risk of developing aplastic anemia (as well as other cancerous processes).

Complications

Anemia
infections
increased bleeding
Arrhythmias and heart failure
Myelodysplastic syndrome

Diagnosis

The diagnostics is based on the data of laboratory studies:

General blood analysis - by determining the number of blood cells
Peripheral blood smear - platelet microscopy
Reticulocytes - study of immature blood cells, reticulocytes
Bone marrow aspiration biopsy - by studying bone marrow tissue

Treatment and management

Treatment of aplastic anemia depends on the cause of the disease and the clinical condition. For example, if aplastic anemia has developed as a result of cancer chemotherapy, a change in the cancer treatment regimen is recommended.

Treatment of aplastic anemia includes:

immunosuppressive therapy during autoaggressive processes. Anti-thymocyte globulin injection and cyclosporins are immunosuppressants used in aplastic anemia (as well as in organ transplantation to prevent rejection).
Blood transfusion - in acute deficiency of blood-shaped elements (cells). Blood transfusions do not cure the disease, but are vital in cases of critically low blood cell counts to prevent life-threatening complications.
Antibiotics - In case of aplastic anemia, the possibility of developing bacterial processes increases.
Allogeneic stem cell transplantation - Transplanted stem cells will replace damaged bone marrow stem cells.

Side effects of treatment:

Tissue removal reaction - during allogeneic (taken from a foreign organism) stem cell transplantation
Increased risk of infections - after immunosuppressive therapy
Hemochromatosis - deposition of excess iron in the blood and organs (especially in the liver, pancreas, heart) as a result of frequent blood transfusions.

Prevention

Aplastic anemia cannot be prevented.

A successful stem cell transplant may cure the disease. The probability of cure is higher in children and people under 40 years of age.

Useful tips

Once a diagnostics of aplastic anemia is made, it is important to follow the diagnostic and treatment recommendations carefully. However, in addition to this, there are a few tips to consider:

Avoid contact activities with high activity - the risk of bleeding and injuries is high, therefore, excessive physical exertion, sports - is not justified.
Protect yourself from viruses and other germs. Complications of any infectious process are expected in the conditions of immunosuppression.
Get enough rest. Daily activity can cause severe exhaustion, weakness, shortness of breath, and changes in heart rhythm. Adequate rest is necessary!
Eat healthy. A balanced diet of proteins, fats and carbohydrates is essential for providing energy.
Be physically active. Light exercise can help you deal with stress.