Aplastic anemia is a condition that occurs when the body stops producing enough new blood cells which leave the patient feeling fatigued and with a higher risk of infections and uncontrolled bleeding. Aplastic anemia is a rare and serious condition and can develop at any age. It may occur suddenly or can occur slowly and get worse over a long period of time.

Aplastic anemia symptoms may include:

• Fatigue
• Shortness of breath with exertion
• Rapid or irregular heart rate
• Pale skin
• Frequent or prolonged infections
• Unexplained or easy bruising
• Nosebleeds and bleeding gums
• Prolonged bleeding from cuts
• Skin rash
• Dizziness
• A headache

Aplastic anemia develops when damage occurs to a person's bone marrow which slows or shuts down
the production of new blood cells. Bone marrow is a red, spongy material inside human bones that
produces stem cells that give rise to other cells. Stem cells in the bone marrow produce blood cell.
They are red cells, white cells, and platelets. In aplastic anemia, the bone marrow is described in
medical terms as aplastic or hypoplastic, meaning that it's empty (aplastic) or contains very few blood
cells (hypoplastic). 

Factors that can cause aplastic anemia:

• Radiation and chemotherapy treatments.
• Exposure to toxic chemicals.
• Use of certain drugs.
• Autoimmune disorders.
• A viral infection.
• Pregnancy, rarely.

Aplastic anemia is a very rare disease, and although it can affect anyone, at any age, it is most common in people aged over 60 – 65 years old and between 10 and 20 years old.

Aplastic Anaemia is the reduced production of blood cells, although, the cells that are produced are normal, work normally and have a normal life span in the blood. An important feature of Aplastic Anaemia is that the marrow is hypocellular, which means that it contains very few blood-forming cells compared with a normal marrow. There may be “pockets” of normal marrow cells left, which means that a single normal marrow specimen might not always be enough to make a diagnosis of illness.

The classification of AA is based on how low the numbers of blood cells have fallen, which can be
found out by a blood count.

Aplastic Anaemia can be classified as non-severe, severe, and very severe.

1.Non-severe aplastic anemia:

• To make a diagnosis of Non-severe aplastic anemia, at least two of the following must be present:
• Hemoglobin less than 100g/L
• Platelet count less than 50 x 109/L
• Neutrophil count is less than 1.5 x 109/L

2.Severe aplastic anemia:

• Hypocellular bone marrow
• A low platelet count
• A low reticulocyte count (less than 20 or 60 x 109/L)
• A neutrophil count less than 0.5 x 109/L

3.Very severe aplastic anemia:

• Hypocellular bone marrow
• A low platelet count
• A low reticulocyte count (less than 20 or 60 x 109/L)
• A low neutrophil count (less than 0.2 x 109/L)

The difference between severe and very severe Aplastic Anemia is how low the quantity of
neutrophils fall which increases the risk of severe infection.

Immunosuppression involves the use of the drugs to control the activity of the immune system and reduce the harm being done to bone marrow stem cells. This is the preferred treatment for patients with non-severe Aplastic Anemia and for patients with severe or very severe Aplastic Anemia who are over 35-50 years old or not able to have a stem cell transplant. If the patient has received immunosuppressive treatment, then he should not have any vaccinations. This is because there is a hypothetical risk that vaccinations might cause his anemia to return.

For younger and fitter patients who have a fully-matched sibling, a donor stem cell transplant is the first treatment of choice. The transplant involves doses of chemotherapy to suppress the body’s immune cells so that they don’t reject the new stem cells followed by a transplant of healthy stem cells from the donor. The treatment is reported as offering a 75% – 90% chance of long term cure.