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Aplastic anemia
What causes aplastic anemia?
Aplastic anemia's exact causes are still not completely clear. Clinically, it is believed that immune dysfunction is a significant factor associated with aplastic anemia. Most cases of aplastic anemia can achieve good therapeutic outcomes through immunosuppressive treatment, which indirectly supports this view. However, some scholars believe that in aplastic anemia, there are patients for whom immunosuppressive treatment is ineffective. This suggests that other factors might exist, such as congenital anomalies in hematopoietic stem and progenitor cells, or abnormalities in the hematopoietic microenvironment, which may also play a role in the development of aplastic anemia.
What are the symptoms of aplastic anemia?
The symptoms of aplastic anemia include three main symptoms: firstly, infections; secondly, anemia; and thirdly, bleeding. Infections occur due to a decrease in white blood cells, especially neutrophils, resulting in poor resistance in patients making them susceptible to subsequent infections, including infections of the lungs, digestive system, urinary system, and skin and mucous membranes. Anemia occurs due to a reduction in red blood cells, causing symptoms such as dizziness, headaches, fatigue, reduced tolerance to physical activity, and poor appetite. A reduction in platelets significantly increases the risk of bleeding, especially when platelets are less than 20 times 10 to the ninth power per liter, which can lead to bleeding in the skin, mucous membranes, organs, and even cerebral hemorrhage.
Which is more severe, aplastic anemia or leukemia?
Aplastic anemia is not leukemia. Leukemia is characterized by more than 20% primary cells in the bone marrow being classified as leukemia. Aplastic anemia, on the other hand, is a bone marrow failure disease, characterized by a reduction in hematopoietic cells in the bone marrow, leading to a decrease in all blood cells. Aplastic anemia can be divided into acute aplastic anemia and chronic aplastic anemia. Acute aplastic anemia has a rapid onset, severe condition, and high mortality rate, while chronic aplastic anemia has a slow onset, longer disease history, and lower mortality rate. Treatment for acute aplastic anemia requires intensified immunotherapy or syngeneic complete match transplantation, whereas treatment for chronic aplastic anemia mainly involves promotive hematopoietic therapy.
What medicine is used for aplastic anemia?
The main drugs used for aplastic anemia are immunosuppressants and cyclosporine. In addition to cyclosporine, low doses of hormones, androgens, and traditional Chinese medicine can also be used to stimulate bone marrow hematopoiesis. If the medication is effective, continue with oral administration; if ineffective, further consideration of bone marrow transplantation is needed. During the treatment process, it is necessary to regularly review the routine blood tests and, if necessary, provide support treatment with red blood cell and platelet transfusions.
Is aplastic anemia serious?
Whether aplastic anemia is severe depends on the specific circumstances of the aplastic anemia. Aplastic anemia can be divided into acute aplastic anemia and chronic aplastic anemia. Among them, acute aplastic anemia has a sudden onset, more severe clinical symptoms, and a higher mortality rate, so it is relatively more severe. Chronic aplastic anemia has a slower onset, and the degree of decrease in blood cells is relatively mild, also making it less severe. However, in cases of acute aplastic anemia, if intensive immunotherapy is administered, the effectiveness can reach 60%-70%, and it can be cured through hematopoietic stem cell transplantation.
Aplastic anemia is caused by how?
The etiology of aplastic anemia is unclear. A more classical theory is the seed, soil, and bug theory. The seed theory suggests that patients with this condition have reduced hematopoietic stem cells in the bone marrow, leading to bone marrow failure. The soil theory refers to abnormal microenvironments in the bone marrow of patients, which leads to an abnormal growth environment for stem cells and consequently hematopoietic disturbances. The bug theory, which is commonly referred to in clinical settings as immune dysfunction, plays a major role in the etiology of this condition.
Aplastic anemia is classified into several types.
Aplastic anemia is divided into two types: acute aplastic anemia and chronic aplastic anemia. Acute aplastic anemia presents suddenly and is severe. Treatment requires intensified immunotherapy or suppression of hematopoietic stem cell transplantation. Chronic aplastic anemia develops slowly, has a longer history, and is relatively less severe. The treatment for chronic aplastic anemia mainly involves immunotherapy combined with therapy to promote hematopoiesis. In addition, regardless of the type, all cases of aplastic anemia require regular complete blood count checks and, when necessary, supportive treatment with red blood cell and platelet transfusions.