Aplastic anemia is a disorder that affects the bone marrow. While the bone marrow continues to produce normal blood cells, the amount of blood cells produced is not enough. This condition can be severe, very severe, or moderate. This condition is rare and in the United States it only affects about three of every one million people. Aplastic anemia treatment primarily focuses on improving the patient’s quality of life, limiting or preventing complications, and alleviating symptoms. A cure is possible, but not for every patient.
Is Treatment Always Necessary?
Treatment may not be necessary when this condition is mild or moderate as long as the condition does not become worse. When severe, immediate medical treatment is necessary to prevent complications. When very severe, emergency medical treatment is necessary because when not treated immediately, it can be fatal.
Blood transfusions are usually necessary when this condition is severe. When platelets are very low, there is the chance of life-threatening bleeding, so if this is the case, a platelet transfusion is necessary. When red blood cells are low, shortness of breath and being very tired are common, therefore, a red blood cell transfusion will be necessary. This treatment plays an important role in managing the symptoms of this condition. Transfusions will be kept to a minimum, however, to prevent too much iron from building up in the patient’s body, to prepare for a possible transplant, and to reduce the chance of the immune system developing antibodies that can attack transfused platelets.
Before a transfusion is administered, it is common to filter out the white blood cells and treat the blood with radiation. These steps help in reducing the risks of a possible transplant, the chance of an immune system reaction occurring, and reduces the risks of other possible complications.
These drugs may be administered to aid the body in producing more blood cells and to try and decrease the patient’s need to have a red blood cell transfusion. However, the bone marrow does not respond to these drugs in many cases. They are often effective when administered after a transplant or immunosuppressive therapy.
Aplastic anemia treatment may include medications to suppress the immune system, stimulate the bone marrow, and treat and prevent infections. To stimulate the bone marrow, medications such as colony-stimulating factors and erythropoietin may be beneficial.
Medications to suppress the immune system may help in preventing the immune system from attacking the body. Complications can be reduced and symptoms relieved. Three medications are often administered at the same time, including cyclosporine, antithymocyte globulin, and methylprednisolone. Long-term treatment may be needed.
This condition often results in low white blood cells, therefore, medications to treat and prevent infections are often given. These may include antivirals and antibiotics.
Stem cell transplants and bone marrow transplants may be beneficial. They are done to replace damaged stem cells with healthy donor cells. The transplant is like a blood transfusion, and once they are in the body, they help in producing new blood cells once they have made their way to the bone marrow.
Those who can have this treatment, often find themselves cured of this condition. Young adults and children who have the severe version of this condition tend to respond best, given they have matched donors and are in good health.
Bakhshi, S. MD. & Abella, E. MD. (2010). Aplastic Anemia. Retrieved on January 11, 2011 from eMedicine: https://emedicine.medscape.com/article/198759-overview
National Heart Lung and Blood Institute. (2011). How is Aplastic Anemia Treated? Retrieved on January 11, 2011 from the National Heart Lung and Blood Institute: https://www.nhlbi.nih.gov/health/dci/Diseases/aplastic/aplastic_treatments.html