Diseases & Conditions Blog

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.

The white blood cells known as neutrophils act as the body’s first defense against infections. Normally the neutrophils are produced in the bone marrow and are released into the bloodstream. In agranulocytosis, most or all of the neutrophils are destroyed, and there is a severe reduction in the number of neutrophils that are circulating in the blood. The result of this reduction in circulating neutrophils is decreased resistance to infection.The disease is often caused by a drug that you are taking for some other disorder. It can also be caused by a viral infection or by an antibody, or normally protective biochemical in your blood, that you develop against your own white blood cells. The disease may be the first sign of leukemia or aplastic anemia (previous article).

What are the Symptoms?

The characteristic symptom of the disease is susceptibility to infection. This is especially true in the mouth and throat, where ulcers often occur. Sometimes, if you have agranulocytosis, infections such as pneumonia progress unusually rapidly and are extremely severe, or even fatal.

What Should be Done?

If you have had one infection after another, see your physician, particularly if you are taking a prescription, VI even a non­prescription drug. Some drugs are known to carry a particular risk of damaging bone mar­row, and your physician will be alert to this possibility. The doctor will probably arrange for a blood test. If the results show that you may have agranulocytosis, a bone marrow biopsy, in which a small amount of bone marrow is removed and examined, will be necessary before your physician can make a definite diagnosis.

What is the Treatment?

Your physician will probably instruct you to stop taking any drug in case it is the cause of the disorder. If the level of granulocytes in your blood is very low, you will probably be given an antibiotic drug to prevent infection. If you already have an infection, or if you have a fever, you will probably be given antibiotics intravenously right away.

In most cases, the outlook for complete recovery from agranulocytosis is very good. Either the drug or the infection causing the disease is eliminated and recovery begins. Cases caused by one of the types of leukemia or aplastic anemia are more complex and so are those in which a difficult-to-control infection develops.