What is aplastic anemia and its causes with treatment?

aplastic anemia

Aplastic anemia is a condition where the bone marrow produces insufficient numbers of blood cells. Aplastic anemia occurs due to a defect in hematopoiesis. Hematopoietic stem cells (HSC) are responsible for forming mature blood cells in adults. In aplastic anemia, the HSC fails to produce enough red blood cells, platelets and white blood cells.

There are many treatment options available for aplastic anemia such as bone marrow transplant, chemotherapy, radiation therapy and immunotherapy. The aplastic anemia treatment cost varies depending upon the type of treatment chosen. The best treatment option for AA is immunosuppressive therapy. Immunosuppressants work by suppressing the immune system. They aim to prevent the body’s own defense mechanisms from attacking its own cells. There are different types of medications that suppress the immune system. These include cyclosporine, azathioprine, methotrexate, mycophenolate mofetil, and corticosteroids.

Other treatments that may help improve the quality of life for people with AA include stem cell transplants, gene therapies, and supportive care.

Causes of aplastic anemia

Aplastic anemia (AA) is a rare condition characterized by bone marrow failure that results in a lack of red blood cells, white blood cells, platelets, and hemoglobin. Aplastic anemia can occur at any age but tends to affect people between 20 and 40 years old. People who have had their spleen removed due to cancer also have a higher risk of developing aplastic anemia. There are two types of aplastic anemias: primary and idiopathic. Primary aplastic anemia occurs without a known cause. Idiopathic aplastic anemia is caused by unknown factors. Both types of aplastic anemia may involve immune system abnormalities. In addition to these two forms, there are other causes of aplastic anemia that are less commonly seen. These include genetic conditions, viral infections, medications, and radiation exposure.

1. Genetic Causes

Genetic disorders that lead to aplastic anemia include Fanconi’s Anemia, Diamond-Blackfan Anemia, Dyskeratosis Congenita, and Bone Marrow Failure Syndromes. These genetic disorders are rare and often require a family history of similar disorders if they are to be diagnosed.

2. Viral Infections

Viral infections that lead to aplasia include Epstein-Barr Virus, Cytomegalovirus, Herpes Simplex Virus, Parvovirus, Varicella Zoster Virus, and Human Immunodeficiency Virus.

3. Medications

Certain medications can result in aplastic anemia including antineoplastic agents, immunosuppressive drugs, and hormones.

4. Radiation Exposure

Radiation exposure can lead to aplastic anemia. This includes ionizing radiation, chemotherapy, radiotherapy, and nuclear accidents.

Treatment of aplastic anemia

Aplastic Anemia (AA) occurs when bone marrow does not produce enough blood cells. It can cause failure of all types of red blood cells. Aplastic anemia is caused by genetic factors or by autoimmune disorders. In rare cases, it may occur spontaneously without any known cause. Symptoms of AA include fatigue, shortness of breath, and pale skin.

1. Bone Marrow Transplant

Bone marrow transplantation (BMT) is a lifesaving treatment for patients who have severe Aplastic Anemia (AA). In this procedure, donor stem cells replace the defective bone marrow with healthy donor stem cells. Stem cells are special cells that can develop into many different kinds of blood cells. When these cells become damaged, they stop making enough blood cells to keep the body alive. 

For example, if someone has leukemia, their immune system stops producing white blood cells to fight off infection. Or, if someone has sickle-cell disease, their red blood cells stop producing hemoglobin, which carries oxygen throughout the body. BMT replaces the patient’s own stem cells with donor stem cells from a matched sibling. If a person’s matched sibling is not available, then a donor stem cell can be selected from any adult unrelated volunteer. 

A related donor may be a parent, child, brother/sister, aunt/uncle, grandparent, or even a friend. After the transplant, recipient stem cells begin to make new blood cells just like donor stem cells did before the transplant. Most people recover from this procedure. However, some people experience problems after their transplant including rejection of the donated stem cells (graft vs host disease), complications due to infections, or side effects from chemotherapy or radiation therapy.

2. Chemotherapy

Chemotherapy drugs are medications that target cancer cells by interfering with specific molecules inside them. As a result, cancer cells cannot function normally and die. There are several types of chemotherapies and each type targets certain parts of the cancer cell. 

Examples of chemotherapies include alkylating agents, antimetabolites, anthracyclines, topoisomerase inhibitors, hormones and targeted therapies. Chemotherapy is often combined with other treatments to improve results and increase survival rates.

3. Radiation Therapy

Radiation kills cancer cells by damaging DNA. Because normal cells divide more frequently than cancer cells, radiation damages the DNA of only the rapidly dividing cancer cells. Radiation also affects surrounding healthy tissue. Radiation therapy can be given in combination with surgery, chemotherapy, hormone therapy, or immunotherapy. Radiation therapy is sometimes called radiotherapy.

4. Immunosuppression

Immunosuppression is a medical condition in which the immune system does not work properly. This can happen naturally in older adults or as a side effect of taking medication. Immune suppression increases the risk of contracting serious illnesses and makes it easier for cancer cells to spread.

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