If you have aplastic anemia, your bone marrow’s production of blood cells decreases. This causes a reduction in the total number of cells in your bloodstream. This may occur gradually or suddenly. In most cases the cause of the problem cannot be identified. Sometimes the cause can be tentatively traced to exposure to a toxic substance such as benzene, certain substances used to dye hair, a drug taken for another disorder, or radiation. Most anticancer drugs produce similar changes in the bone marrow, but the condition usually improves when the drug is discontinued for awhile.

What are the Symptoms?

There are three main groups of symptoms. The decrease in production of red blood cells causes the symptoms of anemia . The decrease in production of granulocytes, a type of white blood cell, makes you more susceptible to infection. Finally, the decrease in platelet production leads to spontaneous bruising, red dots on the skin, and bleeding from the nose, mouth and other sites.

What are the Risks?

The main risks associated with aplastic anemia are infection and bleeding. Both of these may be severe enough to become life­threatening. You may improve spontaneousy or with treatment, but progressive failure of the bone marrow, worsening your condition, may also occur.

What Should be Done?

If you develop any of the symptoms described, see your physician at once. This is especially important if you are taking a drug or working with chemicals or radioactive materials. The physician will probably arrange for a blood test. If the test results show that aplastic anemia may be present, you may need to have a bone marrow biopsy, in which a small amount of bone marrow is removed and examined under the microscope. This examination should allow your physician to make a definite diagnosis.

What is the Treatment?

In cases where the disease is associated with a drug that is being taken for another problem, your physician will strongly consider stopping the drug and finding a suitable substitute. If there is any suspicion of continuing exposure to a toxic compound, you should remove yourself from contact with it.

Your physician will probably treat anemia and hemorrhage, or bleeding, with blood transfusions, and infections with antibiotics, which are usually given intravenously for best results. If you do not have an infection, but your granulocyte count is very low, you still may be given an antibiotic to reduce the chance of infection.

If the disease is severe or if it is growing worse, a bone marrow transplant offers the best hope of recovery. However, the bone marrow transplant has its own hazards. There is also a medication available, but it helps only a few patients.