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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.
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
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.
- 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.
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.
Aplastic Anemia Treatment Cost from trusted Hospitals in Mumbai
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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.
Symptoms
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
- 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.
FAQ Section
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.