Aplastic Anemia

Aplastic anemia occurs when the soft material that makes up the hollow insides of your bones (bone marrow) stops making enough blood cells. There are three types of blood cells:

  • Red blood cells. These carry oxygen to the tissues of the body.  

  • White blood cells. These fight infection.  

  • Platelets. These help your blood clot when you have an injury.  

Aplastic anemia is a rare and serious condition that may develop slowly or rapidly. Even after successful treatment, those with aplastic anemia must be monitored for possible recurrent problems.

CAUSES

Anything that hurts or injures your bone marrow can cause aplastic anemia. Things that may injure marrow include:

  • Radiation and chemotherapy treatment for cancer. These treatments are used to kill cancer cells but also damage other cells.  

  • Exposure to toxic chemicals used in some pesticides and insecticides.  

  • Some medicines, such as those used to treat rheumatoid arthritis.  

  • Autoimmune disorders in which your immune system begins attacking your own body cells.  

  • Viral infections, including hepatitis.  

  • Pregnancy.  

Sometimes the cause is not known.

SYMPTOMS

  • Shortness of breath.  

  • Fatigue.  

  • Lightheadedness or fainting.  

  • Shortness of breath and rapid heart rate, especially with exertion.  

  • Pale skin and lips.  

  • Frequent infections.  

  • Easy bruising and bleeding.  

  • Nosebleeds and bleeding gums.  

  • Prolonged bleeding from cuts.  

  • Severe bleeding during menstrual periods in women.

  • Sore mouth.  

  • Bacterial or fungal infections.

DIAGNOSIS

Blood tests and a bone marrow biopsy are used to diagnose the condition. Additional testing may be done to find the underlying cause of the anemia.

TREATMENT

For mild cases, observation is needed. In severe cases or if complications develop, hospitalization may be necessary. Severe aplastic anemia is life-threatening. Treatment may include:

  • Blood transfusions.  

  • Medicines. Medicines may be given to suppress the immune system if you have an autoimmune disorder. They may also be given to stimulate marrow to make more blood cells. 

  • A procedure where healthy marrow from a donor is given to the person with aplastic anemia (bone marrow transplant). A bone marrow transplant is used to treat severe aplastic anemia. After the transplant, drugs are needed to help prevent the body from rejecting the new marrow. If the procedure is successful, the healthy marrow will begin producing new blood cells. Bone marrow transplants carry risk, and not everyone is a candidate for transplantation. If the body rejects the transplant, it can be life threatening.

HOME CARE INSTRUCTIONS

  • Get plenty of rest and eat a well-balanced diet.  

  • Avoid excessive exercise. Long-term anemia can stress the heart.  

  • When platelets are at low levels, avoid all activities that risk injury. This is important because the risk of bleeding is greater.  

  • Only take over-the-counter or prescription medicines for pain, fever, or discomfort as directed by your health care provider.  

  • Take antibiotics as directed by your health care provider. Make sure you finish them even if you start to feel better.  

  • Protect yourself from infections by washing your hands often. Avoid crowds. Avoid being around sick people.  

  • Keep all follow-up appointments.

  • To prevent aplastic anemia from returning, avoid exposure to toxic chemicals such as:  

  • Insecticides.  

  • Herbicides.  

  • Organic solvents.  

  • Paint removers.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a fever or persistent symptoms for more than 2–3 days.  

  • You have a fever and your symptoms suddenly get worse.  

  • You develop flu-like symptoms.  

  • You develop signs of infection.  

  • You develop infections more frequently.  

  • You have blood in your urine or bowel movements.  

  • You are bruising easily.  

  • You are bleeding from your gums or nose.  

  • You have prolonged bleeding from cuts.  

  • You have increasing shortness of breath or chest pain with exertion.  

  • You develop a rapid heart rate with exertion.  

  • You have increasing fatigue and tiredness.  

  • You develop lightheadedness or fainting.  

  • You develop pale skin and lips.  

  • You develop a sore mouth.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.