Aplastic anemia is a rare but life-threatening condition of blood disorder that occurs when your bone marrow cannot make enough new blood cells for your body to function normally. It can develop quickly or gradually, and it can be mild or serious. Though aplastic anemia can strike anyone, it usually strikes people aged 60 years and older, as well as those between the ages of 15 and 25.
Basic lab tests will show anemia, low platelets, and low white blood cells of varying severity and a bone marrow test is usually needed to confirm the diagnosis. Aplastic anemia may be caused by inherited conditions, drugs, or toxins, but in a vast majority of patients, the cause remains unknown and is thought to be immune destruction of the blood cells and is called immune /acquired aplastic anemia.
The symptoms of aplastic anemia result from the inadequate production of red blood cells, white blood cells, and platelets. Patients often experience fatigue, weakness, and pallor due to a reduced number of red blood cells, leading to insufficient oxygen transport. Additionally, a weakened immune system caused by a decreased production of white blood cells makes individuals more susceptible to infections. The shortage of platelets can result in easy bruising, prolonged bleeding, and an increased risk of hemorrhage. Other symptoms may include rapid heart rate, shortness of breath, and an increased susceptibility to dizziness.
There are many treatment options for Acquired aplastic anemia depending on the age of the patient and the severity of the disease. In a young and otherwise fit patient, a matched bone marrow transplant would be considered the first line of management. In older individuals or younger patients in whom finding an appropriate donor is a challenge, we treat them with immunomodulatory drugs like anti-thymocyte globulin and calcineurin inhibitors. Supportive care including blood and platelet administration, is an important part of management till the body starts to produce its own blood cells after treatment. Due to low white blood cell counts, the body is susceptible to many infections, and treatment of these infections is also an integral part of management.
Aplastic anemia is a challenging disorder for the patient as well as the hematologist. Due to its rarity and complexity, there is a lack of public awareness about aplastic anemia. Awareness about this disease is the most important preliminary step towards its early diagnosis and successful treatment.
(Author: Anusha Swaminathan, Consultant, Hematology, Institute of Blood Disorder, Fortis Healthcare)
