TRAINING and EDUCATION
Patient Education
WHAT IS APLASTIC ANEMIA?
Aplastic anemia is a rare but serious disease of the bone
marrow. Each year, between 600 and 900 people in the United
States are diagnosed with it. Read below for more information
about the cause, treatment, and prognosis of aplastic anemia.
This “Patient Education” tear sheet was produced in collaboration with the Aplastic Anemia & MDS International Foundation
(AA&MDSIF) (www.aamds.org).
What is Aplastic Anemia?
Aplastic anemia is a disease of the bone marrow that occurs when the
bone marrow stops producing enough new blood cells. Bone marrow is
a sponge-like tissue inside the bones that makes stem cells that develop
into red blood cells, white blood cells, and platelets.
In people who have aplastic anemia, the bone marrow’s stem cells are
damaged. Any blood cells that the marrow does make are normal, but
there are not enough of them.
What Causes Aplastic Anemia?
Aplastic anemia is caused by destruction of the blood-forming stem
cells in a person’s bone marrow. Most research suggests that stem cell
destruction occurs because the body’s immune system attacks its own
cells by mistake. Normally, the immune system attacks only foreign substances. When the immune system attacks one’s own body, it is known
as an autoimmune disease; aplastic anemia is generally thought to be
an autoimmune disease.
Aplastic anemia can be either acquired or inherited. “Acquired”
means a person is not born with the condition, but he or she develops
it. “Inherited” means a person’s parents passed the gene for the condition on to the individual.
Acquired aplastic anemia can begin any time in life. About 75 out
of 100 cases of acquired aplastic anemia are idiopathic, meaning they
have no known cause.
Inherited aplastic anemia is passed down through the genes from
parent to child. It is usually diagnosed in childhood and is much
less common than acquired aplastic anemia. People who develop
hereditary aplastic anemia may have other genetic or developmental
abnormalities. For instance, certain inherited conditions can damage
the stem cells and lead to aplastic anemia. Examples include Fanconi
anemia, Shwachman-Diamond syndrome, dyskeratosis congenita,
and Diamond-Blackfan anemia.
About 25 out of 100 cases of acquired aplastic anemia can be
linked to one of several causes. These include:
Low red blood cell count: The most common symptom of a low red
blood cell count is fatigue. A low red blood cell count also can cause
shortness of breath; dizziness, especially when standing up; headaches;
coldness in your hands or feet; pale skin; and chest pain.
Low white blood cell count: Also called neutropenia, a low white
blood cell count can increase the risk for infections.
Low platelet count: A low platelet count, also called thrombocytopenia,
can lead to bleeding problems and cause a person to bruise easily.
How Is Aplastic Anemia Diagnosed?
Diagnosing aplastic anemia can be a complex process. Doctors use
three main tools to help them diagnose and understand each case of
aplastic anemia. These include blood tests, medical history, and bone
marrow examination.
Blood Tests
When trying to figure out the cause of a person’s symptoms, the doctor will ask for blood samples. These samples will be used in a number
of tests, including:
uu Toxins, such as pesticides, arsenic, and benzene
uu Radiation and chemotherapy used to treat cancer
• A complete blood count (CBC) test to measure the number of
each blood cell type in a person’s blood sample
uu Treatments for other autoimmune diseases, such as lupus and
rheumatoid arthritis
• A reticulocyte count to measure the number of young red blood
cells in a person’s blood
uu Pregnancy (sometimes, this type of aplastic anemia improves on
its own after the woman gives birth)
• An EPO, or erythropoietin, count. EPO is a protein made in a
person’s kidneys that causes the bone marrow to make more red
blood cells
uu Infectious diseases, such as hepatitis, Epstein-Barr virus, cytomegalovirus, parvovirus B19, and HIV
Cut out and give to a patient
uu Sometimes, cancer from another part of the body can spread to
the bone and cause aplastic anemia.
What Are the Symptoms of Aplastic Anemia?
The symptoms of aplastic anemia are caused by low blood cell counts.
The symptoms depend on which type of blood cell is affected.
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• Iron level measurements
• Vitamin B-12 and folate levels. A shortage of these vitamins reduces
blood cell production in the bone marrow and causes a drop in the
number of white blood cells, red blood cells, and platelets.
Medical History
To understand what is causing a person’s symptoms and low blood
counts, the doctor will take a detailed medical history. He or she may
ask questions such as:
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