Aplastic anemia is a condition that occurs when your body stops producing enough new blood cells. Aplastic anemia leaves you feeling fatigued and at higher risk of infections and uncontrolled bleeding. A rare and serious condition, aplastic anemia can develop at any age, though it’s most common in younger people.
There’s no prevention for most cases of aplastic anemia. However, avoiding exposure to insecticides, herbicides, organic solvents, paint removers and other toxic chemicals may lower your risk of the disease. This is especially important if you’ve already had aplastic anemia that was caused by toxic chemicals. Exposure to the same compound a second time may cause the condition to return. Once considered nearly always fatal, aplastic anemia has a much better prognosis today, thanks to advances in treatment.
Aplastic anemia Causes
Aplastic anemia develops when damage occurs to your bone marrow, slowing or shutting down the production of new blood cells. Bone marrow is a red, spongy material found within the cavities of many of your bones.
Bone marrow produces stem cells, which give rise to other cells. Stem cells in the bone marrow produce blood cells — red cells, white cells and platelets. Stem cells also make more stem cells. Normally, your body continually replaces blood cells. Red blood cells live about 120 days, platelets about seven days and most white blood cells a day or less before they’re used and absorbed by your body.
Factors that can temporarily or permanently injure bone marrow and affect blood cell production include:
High-dose radiation and chemotherapy treatments. While these cancer-fighting therapies kill cancer cells, they can also damage healthy cells, including stem cells in bone marrow. Aplastic anemia can be a temporary side effect of these treatments.
Exposure to toxic chemicals. Exposure to toxic chemicals, such as some used in pesticides and insecticides, may cause aplastic anemia. Exposure to benzene — an ingredient in gasoline — also has been linked to aplastic anemia. This type of anemia sometimes gets better on its own if you avoid repeated exposure to the chemicals that caused your initial illness.
Autoimmune disorders. An autoimmune disorder, such as lupus, in which your immune system begins attacking healthy cells, may involve stem cells in your bone marrow.
A viral infection. Viral infections that affect bone marrow may play a role in the development of aplastic anemia in some people. Viruses that have been linked to the development of aplastic anemia include hepatitis, Epstein-Barr, cytomegalovirus, parvovirus B-19 and HIV.
Pregnancy. Aplastic anemia that occurs in pregnancy may be related to an autoimmune problem — your immune system may attack your bone marrow during pregnancy.
Unknown factors. In about half the cases, doctors aren’t able to identify the cause of aplastic anemia. This is called idiopathic aplastic anemia.
In aplastic anemia, the bone marrow is described in medical terms as aplastic or hypoplastic — meaning that it’s empty, or contains very few blood cells.
Aplastic anemia is rare. Factors that may increase your risk include:
- Treatment with high-dose radiation or chemotherapy for cancer
- Exposure to toxic chemicals
- Use of some prescription drugs — such as chloramphenicol, which is used to treat bacterial infections, and gold compounds used to treat rheumatoid arthritis — that are known to rarely induce aplastic anemia
- Certain blood diseases, autoimmune disorders and serious infections
- Pregnancy, rarely
Aplastic anemia Symptoms
Aplastic anemia symptoms result from a shortage of one or more types of blood cells. Signs and symptoms may include:
- 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
Aplastic anemia can progress slowly over weeks or months, or it may come on suddenly.
Aplastic anemia diagnosis
Doctors diagnose aplastic anemia using blood tests and bone marrow biopsy.
Aplastic anemia treatments
Severe aplastic anemia, in which your blood cell counts are extremely low, is life-threatening and requires immediate hospitalization for treatment. Mild or moderate aplastic anemia is still serious, but usually doesn’t require hospitalization to treat.
Treatments for aplastic anemia may include observation for mild cases, blood transfusions, medications and, in severe cases, bone marrow transplantation.