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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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.

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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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The main cause of aplastic anemia is.

The causes of aplastic anemia are considered to be of three types: abnormalities in hematopoietic stem cells, abnormalities in the bone marrow microenvironment, and abnormalities in immune factors. Among these, abnormalities in immune factors play a dominant role. Therefore, most patients with aplastic anemia see some improvement after receiving immunosuppressive therapy clinically. However, there is a small subset of patients with aplastic anemia for whom immunosuppressive therapy is not effective, and the causes of the disease in these patients are not well understood and may be congenital, such as congenital dyskeratosis.

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Written by Li Fang Fang
Hematology
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Can aplastic anemia have children?

Acute aplastic anemia, after effective immunotherapy and discontinuation of medication for more than two years, or after hematopoietic stem cell transplantation and discontinuation of medication for more than two years, it is possible to have children. In cases of chronic aplastic anemia, due to long-term oral intake of immunosuppressants and hematopoietic stimulants, having children is not advised. However, if immunosuppressants and hematopoietic drugs are effective and discontinued for more than two years, and blood levels are acceptable, then it is possible to have children.

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Written by Li Fang Fang
Hematology
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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.