Aplastic anemia is a rare disease caused by an abnormality in the bone marrow, so that the organ cannot produce enough blood cells, be it red blood cells, white blood cells, platelets, or all three of them. This condition can be dangerous if the amount of blood is reduced very much and does not get treatment.
Aplastic anemia can come on suddenly or develop slowly. Anyone can get this disease, both men and women. However, aplastic anemia is more common in teenagers, young adults in their early 20s, and the elderly.
Causes of Aplastic Anemia
Based on the cause, there are two types of aplastic anemia, namely:
Acquired aplastic anemia
This type of aplastic anemia is aplastic anemia that occurs after a person is born (not inherited from parents). This type of aplastic anemia is more common in adults.
Most of the cases of acquired aplastic anemia are unknown. However, there are theories that suggest that this condition is largely caused by autoimmune disorders. Autoimmune disorders occur when the immune system mistakenly attacks healthy organs, which in this case is bone marrow.
Based on several studies, it is known that aplastic anemia acquired after birth is more at risk for people who have the following risk factors:
- Viral infections, such as hepatitis B, HIV, cytomegalovirus (CMV), and Epstein-Barr virus.
- Side effects of certain medications, such as chemotherapy for cancer and other drugs, such as antibiotics, anti-convulsions, NSAIDs, and acetazolamide.
- Exposed to chemicals or poisons, such as heavy metals, benzene (gasoline), pesticides, and insecticides.
- Often exposed to high-power radiation or have undergone radiation therapy.
- Pregnancy
Congenital aplastic anemia (inherited aplastic anemia)
Congenital aplastic anemia is caused by genetic disorders inherited from parents. This disease most often occurs in children and adolescents. People with this type of aplastic anemia are at risk of developing certain cancers, such as leukemia.
Symptoms of aplastic anemia
People who suffer from aplastic anemia will show symptoms according to the type of blood that is reduced. But in general, sufferers of aplastic anemia can show the following symptoms:
- Easy bruising or bruising
- Wounds are difficult to heal
- Fatigue
- Hard to breathe
- Dizzy
- Pale skin
- Headache
- Chest pain
- Chest pounding
- Easy to get infections and fever
- Frequent bleeding (for example nosebleeds, easy bruising or bruising, bleeding gums, and bleeding chapter)
Diagnosis of aplastic anemia
If you experience some of the above symptoms, see a doctor immediately. If the doctor suspects that the complaints and symptoms are caused by aplastic anemia, you will likely be referred to a hematologist who handles blood-related diseases.
To determine the diagnosis and look for the cause of aplastic anemia, the doctor will conduct a physical examination and recommend supporting examinations which include a complete blood test, bone marrow biopsy, liver and kidney function tests, and genetic tests.
After the test results are out, the doctor will determine whether the patient has aplastic anemia or not. If the patient is proven to have aplastic anemia, the doctor will provide treatment according to the severity of the disease and the patient's general condition.
Treatment of Aplastic Anemia
To treat aplastic anemia, your doctor can take the following steps:
1. Blood transfusion
Blood transfusion cannot cure aplastic anemia, but can relieve anemia symptoms and provide blood cells that cannot be produced by the bone marrow.
People with severe aplastic anemia may need repeated blood transfusions. This can increase the risk of blood transfusion complications, such as infection, the body's immune reaction to donated blood, to the buildup of iron in red blood cells (hemochromatosis).
2. Stem cell transplantation
Stem cell transplant or what is commonly called stem cell transplant or stem cell aims to rearrange bone marrow with stem cells from a donor. This treatment method is still considered the only treatment option for people with severe aplastic anemia.
Stem cell transplants are generally done for people who are young and have a match with donors (usually siblings). This method can be done through a bone marrow transplant.
Although it is the main therapeutic choice for treating aplastic anemia, the procedure of stem cell transplantation or bone marrow transplantation also carries a risk, namely the rejection of the bone marrow from the donor.
3. Immune suppressing drugs (immunosuppressants)
This drug works by weakening the immune system. This treatment is usually done for people who cannot undergo bone marrow transplantation because they have an autoimmune disorder.
Immunosuppressants can suppress the activity of immune cells that damage the bone marrow, thus helping the bone marrow to recover and produce new blood cells.
In treating aplastic anemia, these immune system-suppressing drugs are usually given along with corticosteroid drugs.
4. Bone marrow stimulants
Certain drugs such as sargramostim, filgrastim and pegfilgrastim, and epoetin alfa can also be used to stimulate the bone marrow to produce new blood cells. This class of drugs can be used in conjunction with immunosuppressant drugs.
5. Antibiotics and antivirals
Aplastic anemia can weaken the immune system due to a smaller number of white blood cells. This makes patients with aplastic anemia vulnerable to infection. To prevent infection, doctors can provide antibiotics or anti-virus which is the cause of the infection.
Aplastic anemia caused by radiation and chemotherapy exposure will usually improve after treatment is complete. If it is caused by a side effect of certain drugs, then this condition will disappear after treatment is stopped.
If you suffer from aplastic anemia, avoid sports or strenuous physical activity that is prone to causing injury and bleeding. In addition, wash your hands more often, vaccinate every year according to doctor's recommendations, and avoid being in the crowd to reduce the risk of contracting the infection.
If you notice symptoms of aplastic anemia or are undergoing treatment for aplastic anemia, don't forget to consult your doctor regularly to get the right treatment and in accordance with your condition.
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