Symptoms and Complications
Symptoms of aplastic anemia occur because of the low blood cell counts. Because of fewer RBCs present, people may have pale skin and feel tired, weak, or short of breath. The low platelet count may cause bruising and bleeding to easily occur. And people with aplastic anemia may be more likely to get bacterial infections because of the low number of WBCs, which fight infection. Cases of infection and hemorrhaging (excessive bleeding) are emergencies and must be treated quickly.
Other symptoms may include a waxy pallor to the skin and mucous membranes, bleeding gums, a lack of energy during exercise, and tinnitus (ringing in the ears). Premenopausal women may have an increased menstrual flow and duration. Massive bleeding is unusual.
Making the Diagnosis
To diagnose aplastic anemia, your doctor will conduct a complete physical exam to check for paleness, bruising, oozing gums, and other unusual signs. He or she will order blood tests to get a complete blood cell count and will probably also arrange for a sample of your bone marrow so it can be checked for abnormalities.
Treatment and Prevention
The first and most important step of treatment is to find out and treat the cause of the aplastic anemia. People with aplastic anemia must do everything they can to avoid getting infections. If any develop, the infections are treated aggressively with antibiotics. Transfusions of red blood cells (RBCs) and platelets may be considered.
Immunosuppressive therapy is used to treat aplastic anemia when it is caused by an autoimmune disorder (a condition where the body is attacking its own bone marrow).
Bone marrow transplantation, which replaces defective bone marrow with healthy cells from a normal donor, may be recommended in severe cases.
Blood transfusions are used to replace the blood cells that are not being produced by the bone marrow the way they should be. Transfusions can replace RBCs and platelets, but white blood cells (WBCs) are harder to transfuse. People with aplastic anemia can receive blood transfusions for many years, but there are some complications that can develop from this treatment. RBC transfusions contain iron that builds up in the body and can damage normal tissues. Proteins on the transfused blood cells stimulate the immune system, and over time antibodies may be produced that destroy the transfused RBCs or platelets.
Also, blood from transfusions may contain viruses or other infections that may be passed on to the recipient. The blood supply today, however, is safer than ever because it's tested for major infections before being used for transfusions.
Growth factor medications are also used. These medications stimulate blood production (e.g., erythropoietin). Herbal treatments and vitamins aren't effective treatments for aplastic anemia, and can in fact make the condition worse and interfere with treatment. They should be taken only under a doctor's supervision. It is very important to have proper nutrition as this will help the body produce blood.
Because aplastic anemia can be life-threatening, quick diagnosis and treatment is crucial. Most people with the disorder can be effectively treated.
The long-term outlook for those who respond to therapy is unknown. As with any serious and chronic condition, there are many emotional side effects that people with aplastic anemia and their families may experience due to the stress of the illness and medical treatments. It's extremely important to get adequate psychosocial support such as from patient support groups, associations, and volunteers, to help cope. Today, people with aplastic anemia and their families can share their experiences with others around the world using the Internet.
Todd Gersten, MD, Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network.