Aplastic Anemia

Aplastic Anemia occurs when the bone marrow stops making enough blood-forming stem cells.

History: The diseases can be traced back to 1888 when a famous German pathologist Dr. Paul Ehrlich studied the case of a pregnant woman who died of bone marrow failure.  However, the disorder was not officially termed as "aplastic anemia" until 1904.

Blood and bone marrow findings: Patients with aplastic anemia typically have low blood cell counts in all three blood lines - red blood cells, white blood cells and platelets. Upon examination, the bone marrow is found to be hypoplastic or aplastic, meaning low growth or no growth of blood-forming stem cells.  Chromosomal abnormalities are not typically found in theses instances.  

Subtypes:  Doctors classify aplastic anemia as moderate (MAA), severe (SAA), or very severe (VSAA), based on the neutrophil count.

Symptoms: The symptoms of aplastic anemia can include increased bleeding, bruising, petechiae, susceptibility to infections, shortness of breath, fatigue, decreased alertness, dizziness and lingering illness.

Incidence and Diagnosis:  Although aplastic anemia can appear at any age, it is diagnosed more often in children and young adults.  Diagnosis begins with a review of your history and symptoms, then your doctor will obtain a Complete Blood Count (CBC) and finally a bone marrow biopsy.

Treatment: In acquired aplastic anemia, immunosuppressive therapy with anti-thymocyte globulin (ATG) plus cyclosporine is the therapy of choice for older patients. It is also used for patients who do not have a matched sibling stem cell donor. Response rates are 70 to 80%. 

For patients younger than 30 years old who have a matched sibling donor, stem cell transplantation replaces the defective bone marrow with healthy cells. This treatment option provides complete recovery for 80% of these patients.