What is Aplastic Anemia?
Aplastic anemia is a type of blood disorder that occurs due to the failure of the bone marrow to produce blood cells.
In this condition, the bone marrow cannot produce one or all of the blood cells, including red blood cells, white blood cells, and platelets.
This condition occurs when the body stops producing enough new blood cells. This leaves the body tired and more susceptible to infections and uncontrolled bleeding.
Aplastic anemia is a rare and serious condition, and it can develop at any age.
This condition can occur suddenly, or it can come on slowly and worsen over time.
Symptoms can be mild or severe. Treatments include medications, blood transfusions or stem cell transplants, also known as bone marrow transplants.
Symptoms of Aplastic Anemia
Each type of blood cell has a specific function in the body.
The main function of red blood cells is to carry oxygen throughout the body, while white blood cells are responsible for fighting infections and platelets are responsible for preventing bleeding.
Complaints that arise in aplastic anemia sufferers can vary from sufferer to sufferer depending on what type of blood cells are deficient.
In conditions of red blood cell deficiency, complaints can include:
- Easily sleepy.
- Weak.
- Feeling weak.
- Pale.
- Dizziness or headache.
- Hard to breathe.
- Chest pain.
- Heart palpitations.
People with aplastic anemia may experience the following symptoms (when in a state of white blood cell deficit):
- Fever.
- Easily sick or have repeated infections.
If the platelet count is low, the body will experience:
- Easy bruising.
- Bleeding, such as nosebleeds or bleeding gums.
Risk Factors for Aplastic Anemia
There are certain factors that can increase the risk of this condition occurring in a person, including:
- Asian race.
- Pregnant mother.
- Age 20-25 years.
- Have an immune system disorder.
- Having cancer.
- Undergoing radiation therapy or chemotherapy.
- Long-term exposure to hazardous chemicals.
Causes of Aplastic Anemia
There are two types of aplastic anemia, namely aplastic anemia that appears at a certain age ( acquired aplastic anemia ) and aplastic anemia that a person has had since birth ( inherited aplastic anemia ).
Aplastic anemia due to genetic causes usually occurs due to damage to the genes in children. Some hereditary diseases that can cause aplastic anemia include:
- Fanconi anemia.
- Shwachman-Diamond syndrome.
- Congenital dyskeratosis.
- Diamond-Blackfan anemia.
This disorder usually occurs in children or at a young age. Meanwhile, aplastic anemia that appears at a certain age usually occurs in adults.
This disease is the most common type of aplastic anemia and is usually associated with disorders that interfere with the immune system (autoimmune diseases), such as:
- History of viral infection.
- Use of drugs such as chloramphenicol.
- History of infections such as hepatitis.
- Hazardous chemicals such as pesticides.
- Pregnancy.
- Radiation or chemotherapy.
In some cases of aplastic anemia, the nature of the disease is idiopathic, meaning doctors do not know the cause.
Diagnosis
To confirm a diagnosis of aplastic anemia, the doctor will ask several questions and perform a physical examination.
In addition, the doctor will also perform supporting examinations to confirm the diagnosis. The types of supporting examinations that doctors usually recommend include:
- Laboratory examination
The procedure includes a complete blood count and reticulocyte count to check levels of hemoglobin, hematocrit, red blood cells, white blood cells, and platelets.
In general, red blood cells and white blood cells in a person’s body are within a certain range.
A medical professional will perform tests to see if the amount of either is lower than normal.
- Bone marrow examination
This procedure aims to determine whether the bone marrow can produce enough blood cells. Bone marrow examination includes aspiration and biopsy.
Aspiration will be carried out by medical experts by taking a sample of bone marrow fluid using a special needle and then examining it under a microscope.
Meanwhile, during a biopsy procedure, a small amount of bone marrow tissue will be taken with a special needle which will be examined under a microscope.
In aplastic anemia, the number of blood cells in the bone marrow is lower than normal.
Treatment
Therapy for aplastic anemia depends on the severity of the disease. In mild cases, treatment is not necessary for sufferers.
In more severe cases, there are treatments to maintain blood cell counts or improve bone marrow function.
Types of treatment that sufferers can undergo include:
1. Medicines
The doctor will provide therapy to prevent and treat infections, stimulate bone marrow, or suppress the immune system to prevent the disease from getting worse.
The type of medication a doctor prescribes to treat an infection usually depends on the type of infection you have.
Doctors can also give antibiotics to sufferers because this condition lowers the body’s immune system, making sufferers more susceptible to disease.
2. Blood transfusion
Blood transfusion aims to maintain sufficient blood cell counts to keep the body healthy.
In addition, blood transfusions can also control bleeding and reduce symptoms by providing red blood cells that the sufferer’s body does not produce.
In the procedure, the two components that the patient will receive are red blood cells and platelets. The transfusion will be given to the patient through an intravenous tube into the blood vessels.
One side effect that can occur after a transfusion is that over time the body can form antibodies against the blood cells from the transfusion.
3. Bone marrow transplant
Bone marrow replacement from a healthy donor could potentially cure aplastic anemia.
In this procedure, the patient is usually a young patient who has a suitable donor such as a sibling.
When a donor is available, the doctor will perform radiation or chemotherapy on the abnormal bone marrow.
Then, there will be a screening of healthy stem cells from the donor to the sufferer. After the injection of healthy cells, the sufferer’s body can start forming new blood cells.
Certain medications such as sargramostim, filgrastim and pegfilgrastim, and eltrombopag work to stimulate the bone marrow to produce new blood cells.
Therefore, doctors usually recommend bone marrow transplantation along with the use of medication.
Complications
Usually, aplastic anemia will heal on its own after undergoing treatment, one of which is a blood transfusion.
However, to prevent complications, sufferers should not do this method continuously.
This is because of the concern that the body will develop antibodies in the blood from the transfusion so that the treatment given will be ineffective.
Prevention
There are various ways to reduce the risk of aplastic anemia, including:
- Maintain cleanliness, for example by washing your hands frequently.
- Take medication according to the instructions for use, for antibiotics it must be based on a doctor’s prescription and advice.
- Eat a balanced nutritious diet.
- Exercise regularly.
- Avoid stress.
- Enough rest.