What is Aplastic Anemia? Causes and Symptoms

Aplastic anemia is an anemia disease caused by the deficiency of stem cells necessary for the production of blood cells. These precursor cells are found in the bone marrow and are called hematopoietic stem cells in the medical literature. Hematopoietic stem cells are very potent precursors with the capacity to self-renew and regenerate all the different cell types found in the blood. In aplastic anemia, there is insufficient production of red blood cells, white blood cells and platelets. Underproduction is present in only one of these cell groups, or more often in all three. Platelets, also known as platelets, are the blood cells involved in blood clotting.

What is Aplastic Anemia?

Aplastic anemia is an autoimmune disease in which the body cannot produce enough blood cells. In autoimmune diseases, the body's immune system mistakenly attacks its own cells. The word "aplastic" means that it cannot fully perform its function. "Anemia" means anemia and may occur due to a red blood cell production disorder. Anemia due to aplastic anemia is the result of the inability of the bone marrow to function fully. Blood cells are produced from stem cells located in the spongy tissue called bone marrow, located in the middle of the bones.

Aplastic anemia progresses with findings such as weakness, susceptibility to infections and uncontrolled bleeding. It is a rare but serious condition and can develop at any age. It may appear suddenly, or it may develop slowly and worsen over time. The disease can be in mild or severe form. Patients with severe aplastic anemia who do not receive treatment have a high risk of death.

Is Aplastic Anemia Cancer?

"Is aplastic anemia cancer?" This question is frequently asked by patients. The answer to this question can be given as a serious but treatable blood disease and not cancer. Contrary to the uncontrolled cell increase in cancer, there is an insufficiency in blood cell production. Aplastic anemia can occur as a result of radiotherapy and chemotherapy used in cancer treatment.

Is Aplastic Anemia Fatal?

Aplastic anemia is a potentially fatal disease if left untreated. disease course or The duration of life depends on the cause of the disease, its severity, the age of the patient and the response to treatment. For example, it is often a short-lived transient when it develops as a result of drug exposure, pregnancy, or low-dose radiation. However, hepatitis is a long-term problem when it develops as a result of certain toxins (benzene, solvents, insecticides), high-dose radiation, or autoimmune diseases. However, it has a five-year survival rate exceeding 80-85% through modern drugs or stem cell transplantation. According to cancer registry data, the overall 5-year survival rate for patients younger than 20 years of age with stem cell / bone marrow transplantation is approximately 80%.

What Causes Aplastic Anemia?

Damage to bone marrow stem cells causes aplastic anemia. When stem cells are damaged, they cannot differentiate into healthy blood cells. The cause of the damage may be congenital or may develop later. Sometimes there is a genetic transmission from parent to child. However, most of the time it is autoimmune, that is, it results from the accidental destruction of stem cells by the immune system. Normally, your immune system only attacks foreign substances. When your immune system attacks your own body, you can say you have an autoimmune disease.

Aplastic anemia can develop at any time in life. In 75% of diagnosed cases, no cause can be found. In the remaining cases, the cause is usually associated with:

• Toxins such as pesticides, arsenic and benzene
• Radiation and chemotherapy used to treat cancer
• Some other autoimmune diseases such as rheumatoid arthritis and lupus Medicines used for
• Pregnancy: Aplastic anemia that develops during pregnancy sometimes heals spontaneously after delivery.
• Infectious diseases such as hepatitis, Epstein-Barr virus, cytomegalovirus, parvovirus B19 and HIV.
• Sometimes, cancer in another part of the body can spread to the bone marrow and cause damage there, causing aplastic anemia.

Hereditary or hereditary aplastic anemia is passed on from parents to children through genes. It is usually diagnosed in childhood and is much less common than acquired aplastic anemia. in patients with hereditary aplastic anemia Other genetic or developmental abnormalities are also found. Some inherited conditions can damage stem cells, leading to aplastic anemia. It can lead to aplastic anemia, including:

• Fanconi anemia
• Shwachman-Diamond syndrome
• Dyskeratosis congenita
• Diamond-Blackfan anemia

A newly discovered type of hereditary aplastic anemia is caused by excessive shortening of the ends of chromosomes called telomeres. This is usually diagnosed in adulthood. Family members of the patient may have aplastic anemia, lung or liver scarring diseases. This type of the disease can only be diagnosed with special tests.

What are the Symptoms of Aplastic Anemia?

Among the symptoms of aplastic anemia, fatigue, weakness and skin rashes are common. The disease can also cause signs of low red blood cells (anaemia), low white blood cell count (neutropenia), or low platelet count (thrombocytopenia). These symptoms may be severe from the outset or get progressively worse over time. Weakness and fatigue are the most common symptoms of anemia. Other symptoms related to anemia can be listed as follows:

• Difficulty breathing
• Chest pain
• Dizziness
• Headache
• Pale skin
• Cold and chilly hands and feet
• Weakness
• Increased heart rate
• Over time, arrhythmia (irregular heartbeat) and Serious heart problems such as heart failure may develop.

Low white blood cells, in other words neutropenia, can cause infections, fever and flu-like diseases that are often difficult to overcome.
Symptoms related to thrombocytopenia can be listed as follows. :

• Easy bruising and bleeding
• Bleeding that is difficult to stop
• Nosebleeds
• Bleeding gums
• Bloody stools or urine
• Heavy menstrual bleeding
• Subcutaneous hemorrhages in the form of small red dots on the skin

What are the Risk Factors of Aplastic Anemia?

Factors that may increase the risk of aplastic anemia include:

• Receiving high-dose radiation or chemotherapy for cancer
• Exposure to toxic chemicals
• Antib called Chloramphenicol certain medications, such as gold compounds used to treat iotic and rheumatoid arthritis
• Certain blood diseases, autoimmune disorders and serious infections
• Pregnancy

How Is Aplastic Anemia Diagnosed?

If the disease is suspected based on the symptoms and physical examination findings, some blood tests and bone marrow biopsy may be performed.

Blood tests: Red blood cell, white blood cell and platelet levels are within a certain reference range in normal individuals (If aplastic anemia is suspected when the levels of these blood cells are very low).

Bone marrow biopsy: For a definitive diagnosis Bone marrow biopsy is done. For this purpose, a small bone marrow sample is taken from a large bone in the body, such as the hip bone, with the help of a needle. The bone marrow sample is examined under a microscope to rule out other blood-related diseases. For diagnosis, the number of cells in the bone marrow is evaluated.

How Is Aplastic Anemia Treated?

Mild cases are followed up without any treatment. In the treatment of more serious cases, drugs are used and blood transfusions are given. In severe cases, a bone marrow transplant may also be required. Severe aplastic anemia with extremely low blood cell counts is life-threatening and requires immediate hospitalization for treatment. The two main treatment options for severe and prolonged aplastic anemia are bone marrow transplantation followed by immunosuppressive therapy. Immunosuppressive therapy is done with drugs to prevent tissue rejection and has serious side effects that suppress the patient's immune system.

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