Anemia is a low level of healthy red blood cells (RBCs). 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 is a rare condition. For some, it can be life-threatening.
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Blood cells start as stem cells in the bone marrow. Aplastic anemia is caused by damage to these stem cells. The damaged cells cannot grow as RBCs and levels in the body begin to drop. It is believed this happens in most people because of an immune system problem. Sometimes drugs, viruses, or toxins may play a role.
Aplastic anemia can also be passed through families.
The risk of aplastic anemia may be higher in those who are:
- Exposed to certain toxins that can be in gas, paint, oil and coal emissions, and industrial solvents
- Getting high-dose radiation and chemotherapy treatments
- Infected with certain viruses
- Taking some illegal drugs
- Taking antibiotics or medicines that treat rheumatoid arthritis
- Diagnosed with bone marrow diseases
Aplastic anemia may cause:
- Fatigue or weakness
- Shortness of breath with activity
- Rapid heart rate
- Pale skin or skin rash
- Easy bruising
- Nosebleeds, bleeding gums, or cuts that bleed for a long time
- Problems with focusing
You will be asked about your symptoms and past health. A physical exam will be done. Blood tests will show the level of RBCs. A bone marrow biopsy will also be done. It will show where the problems are starting and rule out other problems.
Other tests may be needed to look for a cause.
The goal of treatment is to raise the amount of RBCs in the blood. How this is done depends on what is causing the aplastic anemia. Medicines or chemical or radiation exposures causing the anemia may be stopped or reduced.
- Blood Transfusions—Healthy blood from a donor can quickly replace red blood cells. It can help relieve symptoms for a short time. It is not a cure. Once those blood cells wear down, the anemia will come back.
- Immune Suppressing Medicine—This may be given to change or slow the immune system. It can help if stem cell damage is caused by immune system problems. Slowing the immune system will give bone marrow time to recover. It should then be able to make red blood cells again. Steroids may also be given with this medicine.
- Bone Marrow Transplantation—Badly damaged bone marrow may need to be replaced. Healthy bone marrow from a donor should be able to make healthy RBCs again.
Aplastic anemia cannot always be prevented.
Limit exposure to toxins when possible. Be careful around things like gas, paint, oil, coal emissions, and industrial solvents.
- Aplastic anemia and pure red cell aplasia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/aplastic-anemia-and-pure-red-cell-aplasia-prca. Accessed May 13, 2022.
- Explore aplastic anemia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/anemia/aplastic-anemia. Accessed May 13, 2022.
- Killick S.B., Bown N., et al; British Society for Standards in Haematology. Guidelines for the diagnosis and management of adult aplastic anaemia. Br J Haematol, 2016; 172(2): 187-207.
- Marcin Chwistek, MD
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