Aplastic Anemia or Bone Marrow Aplasia
Aplastic anemia is a rare disease where in the bone marrow fails to produce enough blood cells. Bone marrow is a spongy tissue inside the bone that contains stem cells that develop into various types of blood cells. Due to certain reasons at times the bone marrow fails to produces enough of blood cells. This condition is termed bone marrow hypoplasia. When the bone marrow stops producing blood cells at all, the condition is termed bone marrow aplasia.
In cases of bone marrow hypoplasia and aplasia, the blood cells formed are normal, but there is a significant reduction in number. RBCs, WBCs, and platelets are all deficient, giving rise to a variety of complications. Decrease in RBCs result in reduced oxygen carrying capacity and resultant anemia. A decrease in WBCs results in increased susceptibility to infections. Similarly, a decrease in platelets results in bleeding disorders.
Aplastic Anemia Causes:
A small minority of Aplastic anemia sufferers inherit it by birth. This condition is called hereditary Aplastic anemia. The reason is attributed to faulty genes that carry the disease. They also suffer from certain other genetic or developmental abnormalities that contribute to the disease. Some inherited genetic conditions that cause Aplastic anemia are-
A huge majority of the sufferers acquire the disease during their lifetime. Children, young adults, and older adults can all develop the disease. In about eighty percent of the cases, the cause is idiopathic in nature. That means there is no evident cause for the disease.
Acquired Aplastic Anemia is considered as an auto immune disease. In auto immune diseases, the immune system of the body targets its cells mistaking it for foreign bodies. In aplastic anemia, the target of the body is the bone marrow and hematopoietic stem cells. But why the body acts like this remains unclear even today.
However, there is some knowledge regarding certain trigger factors for aplastic anemia. Some of them are-
Toxins like arsenic, benzene, and certain pesticides
Radiation and chemotherapy treatments for tumours and cancers
Treatment for certain autoimmune diseases like rheumatoid arthritis and SLE
Pregnancy, but the condition is very much reversible after child birth
Viral infections with hepatitis, Epstein barr, cytomegalo, Parvo-virus, and HIV
Metastasis or spread of cancers to the bone marrow
Aplastic anemia symptoms:
Some of the common symptoms of Aplastic Anemia are:
Shortness of breath
Exertion while breathing
Irregular or rapid heart beat
Paleness of the skin
Increased frequency of infections
Increased duration of infections
Frequent nose bleeds
Tendency to bruise easily
Aplastic anemia diagnosis:
A diagnosis is usually arrived at by corroborating the findings of medical and family history, physical examination and presenting symptoms with medical lab reports. Some diagnostic tests are complete blood count [CBC] to measure the number of RBCs, WBCs, and platelets, a reticulate count to measure the number of young RBCs etc. Bone marrow biopsy is done to confirm the disease.
Aplastic anemia treatment in India:
The treatment for the disease depends on the severity. In mild cases, the approach is to wait and watch whether the situation improves by itself. Blood transfusions and immuno-suppressants and bone marrow stimulants are recommended for moderate to serious cases. Severe cases may require bone marrow transplantation.
In bone marrow transplant, stem cells are introduced into the bones after suppressing the diseased bone marrow through chemotherapy and radiation. The success of the transplant is higher if the bone marrow donor is a close relative like siblings. The success rate is higher in young patients. Usually, the aplastic anemia life expectancy is about five years. The patient will need to take immuno-suppressants for life.
Bone marrow transplant is done in various hospitals in India. The cost for the same is only a fraction of that in developed countries. In effect, the aplastic anemia treatment cost in India is much lower compared to that in many other countries.
Dos and don'ts during treatment:
Avoid contact sports that can result in injury
Proper body hygiene should be practised
Avoid places from where it is easy to pick up infections
Prescribed medicines should be taken as directed
Vaccinations should be taken to prevent communicable diseases