The pathophysiology of aplastic

anemia.
Nissen C.
Department of Research, University Clinic, Basel,
Switzerland.
Abstract
No single cause can explain aplastic anemia.
Two major factors are involved: An intrinsic
derangement of hemopoietic proliferation
capacity that is essentially compatible with life,
but has to be considered a premalignant
condition. This primarily diseased tissue can be
destroyed by immune mechanisms in an
attempt to achieve self-cure. Therefore,
immunosuppressive therapy can mitigate this
immune reaction but leaves the patient with a
poorly proliferating bone marrow that is prone
to late complications. The clinical presentation
and course depend on the balance of these two
major factors: If the immune reaction is strong,
acute severe aplasia occurs, whereas in
patients with a weak immune reaction the
disease will present itself rather as chronic
pancytopenia with myelodysplastic traits. Co-
involvement of environmental cells in the
disease process is an additional factor. Poor
production of hemopoietic growth factors may
aggravate aplasia and poor immune
competence may allow abnormal clones to
proliferate. All these pathophysiological factors
are genetically determined.

What is Aplastic Anemia?

Posted Feb 20 2010 8:41pm
Aplastic Anemia is a rare but serious
condition in which your body stops
producing enough new blood cells. It is
most common in young people but it can
develop at any age. The disease can
have a sudden onset or progress slowly
and develop symptoms over a period of
weeks or months. It can be either
acute or chronic, but without treatment
the possibility for it to progress and
become fatal is very real.

Causes of Aplastic Anemia

Bone marrow is responsible for
producing the stem cells which produce
our blood cells. Red blood cells, white
blood cells and platelets are all are all
necessary to our body. We either use or
absorb these cells over time; Red blood
cells are replaced approximately every
120 days, most of our white blood cells
are replaced every day and our platelets
live about 7 days before they are
replaced. When the bone marrow’s
ability to replace these cells is affected
the result is aplastic anemia.
There are several factors that can affect
or injure the bone marrow. Autoimmune
disorders can cause the immune system
to turn on itself, attacking healthy cells.
Viral infections such as Epstein-Barr,
Hepatitis, HIV and others that affect
bone marrow can cause an onset of this
type of anemia.
Sometimes medical treatment received
for other conditions such as cancer can
damage our healthy cells while fighting
off the other disease. Radiation and
chemotherapy treatments are examples
of this. When this is the cause, the
anemia is usually a temporary side
effect and not permanent.
Exposure to toxic chemical such as
those found in gasoline, pesticides and
insecticides can cause injury to the bone
marrow, leading to this condition.
Usually, this type will resolve itself by
limiting the exposure to the causative
agent.
Symptoms of Aplastic Anemia
Due to insufficient red blood cells in the
body you will experience fatigue, pale
skin, rapid or irregular heartbeat,
shortness of breath upon exertion,
dizziness or headaches.
Low white blood cells can increase the
development of infections. White blood
cells are what our body uses to fight
infection. The ability to fight any
infection is impaired and you will have
prolonged illness and infection.
Due to low platelets, which are
necessary for the clotting of blood you
will have increased bleeding times,
irregular bleeding such as nosebleeds
or bleeding gums, you will bruise easily
or have unexplained bruising. You may
notice a rash under your skin known as
petechiae.
Treatment of Aplastic Anemia
Due to advances in medicine and
treatment the condition is no longer
considered fatal, the prognosis of those
with aplastic anemia is much better
today. Treatment can include
medications, blood transfusions and
even bone marrow transplant. Since the
ability to fight infections is impaired it is
necessary to prevent them and to treat
them quickly and aggressively if they do
occur.