Aplastic Anemia Treatment

What is Aplastic Anemia?

Aplastic anemia occurs when the bone marrow fails to produce sufficient hematopoietic stem cells, which are responsible for forming:

• White blood cells
• Red blood cells
• Platelets

This rare condition can be inherited or acquired and can appear suddenly or develop gradually. If not treated promptly, it can be life-threatening or lead to other conditions, including cancer. It affects individuals of all ages, with more severity often noted in men.

Causes of Aplastic Anemia

In 70–80% of cases, the cause is unknown (idiopathic). Other possible causes include:

• Hepatitis (5%)
• Medications (6%):
  • Gold salts
  • Sulfonamides
  • Chloramphenicol
  • NSAIDs
  • Antithyroid drugs
  • Phenothiazines
  • Penicillamine
  • Allopurinol
• Toxins (3%):
  • Benzene
  • Canthaxanthin
• Parvovirus B15
• Pregnancy (1%)
• Other rare causes

Symptoms of Aplastic Anemia

• Low red blood cells: pale skin, fatigue, dizziness, fast heartbeat
• Low platelets: bruising, abnormal bleeding
• Low white cells: infections, fever

Diagnosis of Aplastic Anemia

• Blood test: shows low counts of RBCs, WBCs, and platelets
• Bone marrow biopsy: confirms hypoplasia or aplasia
• Excludes other conditions: leukemia, MDS, myelofibrosis, etc.

Treatment Options

Treatment should start immediately after diagnosis. It includes:

1. Remove External Causes

If due to a drug, toxin, or radiation exposure, these should be eliminated.

2. Immunosuppressive Therapy

Used to suppress the immune attack on bone marrow.

• Anti-thymocyte globulin (ATG) or antilymphocyte globulin (ALH)
• Cyclosporine
• Steroids (e.g., methylprednisolone)

About 70% respond to this therapy, though relapses are possible.

3. Bone Marrow Transplant

Preferred in younger patients or those with a compatible donor.

Common Complications

• Infections
• Bleeding
• Risk of relapse

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Frequently Asked Questions

Q: Is Aplastic Anemia Life-Threatening?
A: It can be, especially if blood cell levels remain low despite treatment.

Q: Who Is Eligible for Treatment?
A: Those with symptoms like infections, rapid heartbeat, fatigue, nosebleeds.

Q: Who Is Not Eligible?
A: Not everyone qualifies for a bone marrow transplant; mainly younger patients succeed.

Q: Are There Side Effects of Bone Marrow Transplant?
A: Reactions can include skin irritation, immune complications, sterility, and hair loss.

Q: Post-Treatment Guidelines?
A: Avoid infections, monitor fevers, avoid injuries, maintain hygiene.

Q: Recovery Time?
A: Varies by severity; drug therapy takes 3–6 months.

Q: Are Results Permanent?
A: Can be, but relapses are possible when stopping medication.

Q: Alternatives?
A: No true alternatives; immunosuppressive therapy is fallback if transplant isn’t feasible.

Q: Safety of Donating Bone Marrow?
A: Generally safe, recovery is within weeks.

Q: Success Rate of Bone Marrow Transplant?
A: 70–90% with sibling donor; ~50% with unrelated donor.

Q: Visa & Travel Requirements to India for Treatment?
A: Some nationalities need yellow fever/polio vaccinations; medical visa with documentation is essential.