Aplastic anemia is a rare disorder characterized by decreased ability of the body to produce blood and thus these patients have decreased hemoglobin, WBC, and platelets.
What are the symptoms?
Fatigue can be seen due to decreased hemoglobin. Recurrent infections occur due to decreased WBC and tendency to bleeding occurs due to decreased platelets.
What are the causes?
Cause is mostly unidentified. It is thought that it is because of body’s immunity working against the body’s Hematopoietic stem cells (HSCs). HSCs are the cells which have the capacity to produce all types of blood related cells in the body. In some cases it can occurs secondary to certain drugs, radiation and infections. It is sometimes inherited in families as a part of inherited marrow failure syndromes.
How is it diagnosed?
It is diagnosed with the help of a bone marrow test which shows its decreased ability to produce cells.
What are the types of Aplastic Anemia?
If the patient is requiring recurrent transfusions or the platelets remain <20000/cumm or the Absolute neutrophil count is < 500/cumm is is called as severe Aplastic Anemia.
What happens if the patient is not treated?
These patients can have recurrent symptoms of fatigue, bleeding and infection. Rarely the infections and bleeding can be so severe so as to cost the life of the patient.
Why Transplant when the patient can be treated with Injections and tablets?
The Outcomes of transplant in Aplastic Anemia are very good. If young patients are transplanted as soon as they are diagnosed then chances of cure are as good as 90%.
Also in the inherited diseases, option of injection is not available. The ATG injection + Eltrombopeg + Cyclosporine are very expensive and if Revolade is omitted from the treatment to cut the cost, the outcome of treatment is not very good.
Does Transplant endure freedom from Aplastic Anemia?
Transplant comes with its fair share of problems, however when planned in the right time, with the matched donor, there is a 90% chance that these patients will have cure from Aplastic Anemia
Treatment options include
- Allogenic Stem Cell Transplant: Here HSCs from a healthy donor are taken and transfused to the patient in a particular protocol, thus providing the person with the capacity to produce normal cells.
- ATG + Eltrombopeg + Cyclosporine: Here patient is treated with some injection and orals tablets.
How to choose the best treatment?
For Non Severe disease ATG based treatments are preferred.
For Severe disease in Patient < 50years old transplant is preferred.