Aplastic anemia is a condition that occurs when the body reduces the production of new blood cells to the point that there is a deficiency. This blood condition occurs when the bone marrow and the stem cells that generate new blood cells (hematopoietic stem cells) are impaired. This disease leads to a deficiency in the amount of all the blood cell types (pancytopenia) including a deficiency of red blood cells (anemia, platelets (thrombocytopenia) and also white blood cells (leukopenia). The term “plastic” refers to the ability of the stem cells to produce mature blood cells, so ‘Aplastic’ describes the loss of that ability. This disease is more prevalent in kids, and also in young adults, especially those in their twenties but it can occur to anyone at any age. This disease is known to be caused by many factors. Some of these factors include genetics, medications, radiation, immune system diseases, chemotherapy.
Aplastic anemia can be diagnosed by bone marrow biopsy. This involves using a special needle and syringe to take a sample of the bone marrow from inside the spine. The bone marrow usually has about thirty to seventy percent stem cells, however, the majority of these cells are replaced by adipose tissue over time. Aplastic anemia can be treated by administering immunosuppressive medications like corticosteroids. Stem cell transplant is also a popular and effective treatment of aplastic anemia. There are varieties of solutions provided by those in the stem cell business. Hematopoietic stem cells are used, especially for young adults, under the age of thirty. Exosomes are also used for the treatment of this blood condition.
What Causes Aplastic Anemia?
Aplastic anemia can be caused by many factors. Some of the common factors that lead to this blood disorder include genetics, immune diseases, radiations, medications and chemical exposure. However, sometimes the cause is not known (idiopathic factors). Below are some of the factors that are known to cause Aplastic anemia :
- Inherited Causes: This accounts for a quarter of children with aplastic anemia and about 10% of adults with the condition. Many people who develop aplastic anemia due to an inherited or genetic cause also have or develop prominent physical abnormalities in structure and form, although bone marrow failure is usually the first sign to be noticed.
- Radiation: Exposure to heavy doses of ionizing radiation can lead to the development of aplastic anemia. This radiation leads to the destruction of the bone marrow, and subsequently the defect in the production of the blood cells.
- Chemical exposure: Exposure to some toxic chemicals also increases the risk of having aplastic anemia. Some of these chemicals include pesticide and insecticides. In addition, exposure to chemicals such as benzene has also been linked to the development of aplastic anemia.
- Medications: There are some drugs that lead to the development of aplastic anemia. Some of these medications are used in the treatment of diseases such as rheumatoid arthritis. In addition, some antibiotics have been implicated as a factor in aplastic anemia.
- Pregnancy: Aplastic anemia can be caused by an autoimmune disease during pregnancy. This occurs as a result of autoantibodies. These antibodies attack and destroy the body’s stem cells and other components of the bone marrow, leading to aplastic anemia.
- Infections: There are some infectious diseases that can lead to aplastic anemia. However, viral infections are the most common ones to lead to aplastic anemia. Some viruses that have been linked with this include Epstein-Barr virus, hepatitis virus, parvovirus, and cytomegalovirus.
- Severe nutritional deficiencies: Deficiencies in vitamin B12 and folate can trigger an autoimmune reaction leading to the development of aplastic anemia.
- Other factors: Other factors that could lead to aplastic anemia. For example, viral hepatitis has been identified as a possible cause of the disorder. However, there are cases where doctors are not able to identify the cause of the disease. This is known as idiopathic aplastic anemia.
Risk Factors Of Aplastic Anemia
- Radiations: People exposed to a lot of radiations have a high risk of developing aplastic anemia. For example, cancer patients undergoing regular and high doses of radiations are prone to developing this disease.
- Chemotherapy: Similar to radiotherapy. Patients undergoing heavy dosage of chemotherapy are more predisposed to having aplastic anemia. This is because the chemicals are capable of destroying the bone marrow, and also its constituents.
- Pregnancy: Although this is uncommon, autoantibodies might attack healthy cells and the bone marrow. Pregnancy tends to increase the risk of having aplastic anemia.
- Infections: There are some diseases that could facilitate the development of aplastic anemia. Examples of these diseases are viral hepatitis, Epstein-Barr viruses and so on.
- Medications: Some drugs are capable of causing aplastic anemia. These drugs could even be medications prescribed by physicians. Examples of these are drugs used for the treatment of diseases such as rheumatoid arthritis. Another example is chloramphenicol, which is used for the treatment of bacterial infections.
Signs And Symptoms Of Aplastic Anemia?
Patients affected by aplastic anemia usually presents with a lot of symptoms, considering that it affects all the cellular components of the blood. Below are some of the signs and symptoms of aplastic anemia;
- Tiredness: Tiredness occurs due to the insufficient amount of red blood cells. The red blood cells are responsible for transporting oxygen. A reduction in the number of red blood cells will lead to anemia, which eventually leads to easy fatigability.
- Shortness of breath: This occurs after some exertion possibly after walking for a while. It is due to the low level of oxygen and nutrients being delivered to the tissues because of the low number of red blood cells.
- Increased and irregular heart rate: This is also known as tachycardia. Patients have a heart rate that is more than 100 beats per minute.
- Skin pallor: Patients affected by aplastic anemia commonly presents with pale skin. This might be attributed to the reduced number of red cells and hemoglobin in the blood.
- Headache
- Easy bleeding: This occurs due to the number of platelets in the blood. Aplastic anemia leads to thrombocytopenia which eventually which eventually leads to easy bleeding, and other symptoms such as petechiae, prolonged bleeding, hemoptysis and so on.
- Infections: Aplastic anemia leads to the deficiency of white blood cells. This exposes and predisposes the affected individual to diseases and infections.
- Skin diseases: Patient might present with skin diseases such as skin rash and healing might take longer.
Treatment of Aplastic Anemia
The treatment of this disease depends largely on the severity of the condition. For the mildly severe aplastic anemia, the physician might just need to observe, while for serious cases, blood transfusion and medications like immunosuppressants might need to be administered.
Stem Cell Therapy And Aplastic Anemia
Stem cells have been in use for the treatment of aplastic anemia for a long time. Stem cells can be gotten from a donor if the patient has severe aplastic anemia. Stem cells are unique cells that are capable of self-regeneration and proliferation. Hematopoietic stem cells are gotten from a donor, processed, and then injected intravenously to the patient, the recipient. The patients are usually given some medications to suppress the immune system and reduce the risk of rejection.
References
European Atherosclerosis Society. (2015). Atherosclerosis Supplements, 19, p.iv.
Raggi, P. (2016). Inflammation, depression and atherosclerosis or depression, inflammation and atherosclerosis?. Atherosclerosis, 251, pp.542-543.
Smoking and atherosclerosis. (2002). Atherosclerosis Supplements, 3(2), p.230.
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