Aplastic Anemia

Aplastic anemia is a condition in which the bone marrow is unable to produce enough new blood cells. This disease causes the number of one or all types of red blood cells to decrease.

Aplastic anemia can affect anyone, but is more common in people in their early 20s and the elderly. Early symptoms of aplastic anemia are fatigue, pale skin, shortness of breath, and dizziness. People with this condition are also susceptible to infection due to a lack of leukocytes or white blood cells (leukopenia).

Causes of Aplastic Anemia

Aplastic anemia occurs because stem cells in the bone marrow are damaged. This stem cell damage causes blood cell production to slow down or even decrease. As a result, the number of red blood cells (erythrocytes), white blood cells (leukocytes), lymphocytes, and platelets (thrombocytes) decreases, or is called pancytopenia.

Some conditions or diseases that can cause aplastic anemia are:

• Autoimmune disease
  Autoimmune disease occurs when the immune system attacks healthy cells, including stem cells in the bone marrow. If not treated immediately, the risk of developing aplastic anemia will increase.
• Genetic disorders
  A person can get aplastic anemia if they have a family history of the disease. In addition, a genetic disorder called Fanconi anemia can also cause this disease.
• Viral infections
  Viral infections that attack the bone marrow can also cause aplastic anemia. Some types of viruses that are often associated with aplastic anemia are Hepatitis, Epstein-Barr, Cytomegalovirus, Parvovirus B19 (human parvovirus ), and human immunodeficiency virus (HIV).
• Radiotherapy and chemotherapy
  Radiotherapy and chemotherapy are types of therapy to treat cancer. These methods carry the risk of side effects, including damaging stem cells in the bone marrow and increasing the risk of aplastic anemia.
• Use of certain medications
  Certain medications, such as the antibiotic chloramphenicol and drugs to treat rheumatoid arthritis, can cause bone marrow damage and increase the risk of developing aplastic anemia.
• Exposure to chemicals
  Continuous exposure to chemicals, such as pesticides, insecticides, and benzene, can also cause aplastic anemia.
• Pregnancy Pregnancy
  sometimes causes the pregnant mother’s immune system to attack and damage the bone marrow.

In addition to the conditions already described, aplastic anemia can be caused by unknown factors. This condition is often called idiopathic aplastic anemia.

Symptoms of Aplastic Anemia

Each type of blood cell has a different function. Leukocytes play a role in the body’s immunity, while platelets play an important role in the blood clotting process. Meanwhile, erythrocytes contain hemoglobin so they play a role in distributing oxygen and nutrients throughout the body.

Symptoms of aplastic anemia can vary, depending on the function of the blood cells affected. However, common symptoms include:

• Easily tired and weak
• Hard to breathe
• Pale skin
• Dizzy
• Headache
• Fever
• Skin bruises or bleeds easily
• Recurrent and slow-healing infections
• Nosebleed

When to see a doctor

See a doctor immediately if you experience the above symptoms. You are also advised to seek medical help immediately if you experience bleeding that is difficult to stop or repeated infections that are difficult to heal.

Diagnosis of Aplastic Anemia

To diagnose aplastic anemia, the doctor will ask questions about the patient’s complaints, the patient’s and family’s medical history, and the medications being taken, followed by a physical examination.

After that, to confirm the diagnosis, the doctor will carry out supporting examinations in the form of:

• Blood tests
  Blood tests are done to check the levels of red blood cells, white blood cells, platelets, and hemoglobin. Aplastic anemia is suspected if the number of any of these cells or all of them are below normal.
• Bone marrow biopsy A
  bone marrow biopsy is a test that involves taking a sample of bone marrow and examining it under a microscope. This test is also done to rule out other possible causes.

Aplastic Anemia Treatment

Treatment for aplastic anemia depends on the condition and severity experienced by the patient. Here are the types of treatment for aplastic anemia:

1. Antibiotics and antivirals

People with aplastic anemia are susceptible to infection. Therefore, antibiotics or antivirals will be given by the doctor to treat the infection.

2. Blood transfusion

If the level and number of blood cells are drastically reduced, a blood transfusion can be given to relieve symptoms and meet the need for blood cells.

3. Immunosuppressants

Immunosuppressant drugs are given to suppress the activity of the immune system that damages the bone marrow. Immunosuppressants will be given to people with aplastic anemia due to autoimmune diseases. Some types of drugs used are ciclosporin or corticosteroids .

4. Stem cell transplantation

Stem cell transplantation or bone marrow transplantation is done to replace damaged cells with healthy cells. This method is usually done on patients under the age of 40 and get a suitable donor, such as a sibling.

This method can also be done in patients whose symptoms do not improve after using immunosuppressants. However, this procedure also carries risks if the patient’s body rejects the donor’s stem cells.

5. Bone marrow stimulant

Drugs, such as filgrastim, pegfilgrastim, epoetin alfa, or eltrombopag, can be given to stimulate the bone marrow to produce new blood cells. This method is often combined with immunosuppressants.

Complications of Aplastic Anemia

If left untreated, aplastic anemia can cause complications such as:

• Severe infection
• Bleeding
• Accumulation of iron in the body (hemochromatosis)
• Myelodysplastic syndrome
• Blood cancer (leukemia)
• Lymph node cancer (lymphoma)

Prevention of Aplastic Anemia

There is no way to prevent aplastic anemia. However, to reduce the risk of developing aplastic anemia, it is best to avoid exposure to chemicals, such as pesticides, insecticides, organic solvents, and paint removers.

If you suffer from aplastic anemia, there are several things you can do to prevent this condition from getting worse or causing complications, namely:

• See a doctor for regular medical treatment and check-ups
• Wash your hands frequently, especially after using the toilet or doing outdoor activities.
• Avoid sports that involve physical contact, to prevent bleeding.
• Get enough rest after activities and sleep at night
• Complete immunizations, especially for children, by consulting a doctor first.

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