Which is more severe, aplastic anemia or leukemia?

Written by Li Fang Fang
Hematology
Updated on September 14, 2024
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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.

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Written by Li Fang Fang
Hematology
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Can aplastic anemia be cured completely?

Aplastic anemia clinically is categorized into acute aplastic anemia and chronic aplastic anemia. Acute aplastic anemia appears suddenly and is severe, with a short survival period. Chronic aplastic anemia develops slowly, has a longer history, and is relatively milder in condition. Whether it is acute aplastic anemia or chronic aplastic anemia, curative treatment can only be achieved through allogeneic hematopoietic stem cell transplantation. Although allogeneic hematopoietic stem cell transplantation offers a potential cure for aplastic anemia, there is also a certain rate of failure. Additionally, post-transplant, there is a presence of immune rejection.

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Written by Li Fang Fang
Hematology
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The etiology of aplastic anemia

The etiology of aplastic anemia currently has no absolute cause, but the more supported theories concerning its etiology include the soil, pest, and seed theories. The soil theory refers to abnormalities in the microenvironment within the bone marrow, which causes an abnormal growth environment for hematopoietic stem cells, consequently limiting their growth. The seed theory indicates a decrease in the number and quality of hematopoietic stem cells in the bone marrow, leading to bone marrow regeneration failure. The pest theory refers to immunological factors, which play a significant role in aplastic anemia, suggesting a disorder in the patient's immune function that leads to bone marrow regeneration failure.

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Written by Zhang Xiao Le
Hematology
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What tests should be done to diagnose aplastic anemia?

The diagnostic criteria for aplastic anemia include a decrease in all blood cells, generally no enlargement of the liver or spleen, reduced or severe reduction in bone marrow hyperplasia in multiple sites, and exclusion of other diseases causing a decrease in all blood cells. Therefore, the diagnosis of aplastic anemia requires the following tests: complete blood count, reticulocyte count, abdominal ultrasound, bone marrow cytology, bone marrow chromosome analysis, bone marrow biopsy, rheumatoid immune indicators, and peripheral blood T-cell subgroups. Additionally, for patients suspected of having aplastic anemia, further flow cytometry and differentiation from myelodysplastic syndromes are sometimes necessary.

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Written by Li Fang Fang
Hematology
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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.

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Written by Li Fang Fang
Hematology
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Can aplastic anemia be cured?

Aplastic anemia is divided into acute aplastic anemia and chronic aplastic anemia. Acute aplastic anemia can be cured by intensive immunotherapy or syngeneic hematopoietic stem cell transplantation. However, not all cases of acute aplastic anemia can be cured by these two treatments, with the cure rate being approximately 60%-70%. For chronic aplastic anemia, the main treatment currently is oral immunosuppressive therapy, which usually cannot cure the condition unless allogeneic hematopoietic stem cell transplantation is performed. However, if patients with chronic aplastic anemia are on oral immunosuppressive therapy, they can maintain a relatively good condition and typically do not opt for allogeneic hematopoietic stem cell transplantation.