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Aplastic Anemia Treatment

Bone Marrow consists of the Hematopoietic Progenitor cells which are stem cells that differentiate to form the three types of Blood cells in our body- Red Blood Cells, White Blood Cells and Platelets. The condition of the destruction of these stem cells of the Bone Marrow is known as Aplastic Anaemia. As a result, the bone marrow cannot carry out sufficient amount of Haematopoiesis and fails to produce sufficient amount of blood cells to meet the need of our body. This adversely affects transport of oxygen in the body, blood clotting and the ability to fight infections in our body.

Aplastic Anaemia can be inherited or acquired. The former is due to genetic defects, whereas the latter occurs due to several reasons. Acquired Aplastic Anaemia occurs can occur due to some medications, HIV or Epstein-Barr virus, Auto- immune disorders or even from Chemotherapy during treatment of cancer. 

 

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Symptoms

Aplastic anaemia results in the reduced count of all the three types of Blood cells in the body. Due to the decrease in Red Blood Cells, Fatigue and Weakness like symptoms are observed in the body. The lower count of White Blood Cells cause the Fever and recurrent infections and the decrease in Platelet count results in prolonged bleeding in the body.  

The symptoms of Aplastic Anemia are:

  • Fatigue, Weakness and Dizziness
  • Easy Bruising and prolonged Bleeding from cuts
  • Gingival and Nose Bleeding 
  • Shortness of breath, exertion and chest pain
  • Pallor
  • Irregular heart rate
  • Recurring infections and Fever
  • Skin Rash- the appearance of small red dots on the skin that indicates bleeding under the skin
  • Headache

Diagnosis

A complete blood count is necessary if these symptoms are observed. The cells of the bone marrow, taken from the hipbone usually, have to be examined under the microscope by an experienced Physician at a Bone Marrow Failure Speciality Center. Blood and Laboratory Tests have to be carried out along with Bone Marrow aspiration and a Biopsy to assess cellularity qualitatively and quantitatively. Other related tests may also be taken to test kidney function and liver function. 

Treatment

There are various types of Aplastic Anaemia. Depending on severity, a suitable treatment is prescribed to the patient. 
  • Blood Transfusions are done to get a relief from the bleeding and to raise the blood cell counts. However, this is not a long term alternative due to the possibility of accumulation of excess iron in the liver and a complete recovery is highly unlikely. 
  • Bone Marrow Transplants were first found effective due to its success in treating Aplastic Anaemia. During this procedure, the ineffective bone marrow is destroyed and is replaced by the bone marrow from a compatible donor. 

  • Immunosuppressants such as Cyclosporine and ATG are given to patients who have Acquired Aplastic Anaemia due to Auto-immune disorders. However, this treatment is only temporary. 
     
  • Bone Marrow Stimulants like certain drugs are given to the patient with moderate Aplastic Anaemia which aid in Haematopoiesis. 

Risks

In case of a Bone Marrow Transplant, the main risk involved is Graft-versus-Host disease in which the donor cells start to attack those of the recipient and hence causes problems in relation to immunity. In addition to this, there is a chance of Graft rejection in which the donor stem cells do not function effectively in the recipient and fail to differentiate into blood cells. This would lead to thrombocytopenia and anaemia. The patient may also be prone to several infections after surgery and may experience nausea, vomiting, fatigue, weakness and diarrhoea. There are possibilities of damages to the liver, delayed growth in children, clotting in blood vessels and even bleeding in the essential organs of the body.

After Procedure

Care must be taken after a bone marrow transplant in case of aplastic anemia. After a bone marrow transplant, the patient is monitored by the doctor for signs of graft rejection. A medication for GVHD is given to prevent it from occurring. Antifungals, antivirals and antibiotics are also given in order to prevent all sorts of infections. Regular blood tests are conducted in order to check if blood counts are back to normal and to check the functioning of the donor’s stem cells in the recipient. The patient may require blood transfusions in case of too much blood loss or slow recovery.     

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