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.
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.
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.
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.
MBBS | MD(General Medicine) | DM(Clinical Hematology) - Hematologist