What is Aplastic Anaemia ?
Aplastic anaemia is not a single disease, but a group of closely related disorders characterized by the failure of the bone marrow to produce all three types of blood cells: red blood cells, white blood cells and platelets. In aplastic anaemia, the bone marrow stops producing enough new blood cells. This means that you have not only a deficit of red blood cells but also a shortage of white blood cells to fight germs and platelets to help blood clot. You're at higher risk of infections and uncontrolled bleeding. The exact cause of aplastic anaemia is unknown, although it has been linked to exposure to chemicals such as benzene and radiation. It is also believed that some cases of aplastic anaemia are inherited and that some cases are due to a viral infection and other infections. In our country the incidence is higher than other western countries due to infections. The cause is a mistaken immune system response that destroys bone marrow. A condition known as secondary aplastic anaemia can develop when bone marrow is damaged by cancer, chemotherapy, certain medications, pregnancy or exposure to toxic substances.
What are the symptoms?
Tiredness, looking pale, rapid heart rate, repeated infections, fever, boils, bleeding, heavy periods and bruising. You can experience one or more of the above symptoms and signs.
How is it diagnosed?
It can be suspected on a simple blood test. We will be doing further tests to rule out underlying infection or other disease. Bone marrow test is necessary for the accurate diagnosis and will be performed. Special tests on the bone marrow will be done and will be explained to you.
Can it be cured?
Yes. It can be cured in around 70% of patients who receive appropriate treatment.
What are the treatment options?
Antithymocyte Globulin (ALG/ATG)
This is an antibody produced in either horse or rabbit. It is given over a period of 5 days and you will need admission in a hospital for atleast 3 weeks. It is expensive.
It is usually started after finishing ATG/ALG and is given for atleast 1 year. It has to be stopped very slowly. ATG + Ciclosporine are the standard of care for Aplastic Anaemia worldwide. It is expensive treatment and we will discuss the cost and other issues with you at the time of actual treatment.
Bone marrow transplant
It can be curative and the success rate can be between 70-90%. It can cause some long term problems. You can ask for a separate information sheet on Bone marrow transplant.
They are anabolic steroids which can help in increasing the blood counts.
They were among the first treatment option for aplastic anaemia. They can cause improvement in the blood counts and patient may need it for few months.
it will be given to increase your haemoglobin. Some patients will need regular platelet transfusion as well.
Patients are usually susceptible to repeated serious infections and they may need admission to hospital for the treatment or sometime the drugs can be given as an outpatient prescription to prevent the infection.
Are there any late complications?
Yes. In some patients the disease can relapse (come back). It can be again treated.