A person is said to have anaemia when they have a deficiency in the number or quality of red blood cells in their body; meaning that the level of red blood cells or the oxygen-carrying capacity is lower than normal. Red blood cells are the ones that carry oxygen around the body and when the oxygen-carrying capacity is insufficient, it does not meet the physical needs in terms of a person’s age, gender, altitude, smoking and pregnancy status.
Anaemia can be of different types. This article, however, will focus on aplastic anaemia which occurs when the body stops producing enough new blood cells. It occurs when the bone marrow is damaged causing a shutting or slowing down in the production of new blood cells. Factors that can cause damage to bone marrow include:
- Chemotherapy and radiation therapy cancer treatments,
- The use of certain drugs like antibiotics,
- Exposure to toxic chemicals like benzene,
- Pregnancy, and
- Viral infections such as hepatitis.
- Some common symptoms of this type of anaemia are:
- Shortness of breath with exertion,
- Easy bruising,
- Bleeding gums,
- Pale skin,
- Headache, and
- Rapid or irregular heart rate.
Aplastic anaemia is diagnosed through blood tests to check the levels of red and white blood cells, and a bone marrow biopsy that involves checking a bone marrow sample for blood-related diseases.
Treating Aplastic Anaemia
Blood transfusion is done to control bleeding and relieve anaemia symptoms. The transfusion does not cure the anaemia but relieves symptoms as it aids in production of blood cells that the bone marrow fails to produce. The transfusion is done for red blood cells and platelets which help relieve anaemia and prevent excessive bleeding, respectively.
For severe aplastic anaemia, stem cell transplant is a better, more effective treatment option. Stem cell transplant (also referred to as bone marrow transplant) involves harvesting bone marrow from an individual or a donor which is then used to replace the damaged bone marrow. This treatment is commonly done for younger patients and in most cases the bone marrow is taken from a sibling. The two types of transplants are:
1. Autologous transplant: when bone marrow is harvested from the patient, and
2. Allogenic transplant: if the bone marrow is received from a donor.
The entire treatment process takes time – from finding a donor, depleting the diseased bone marrow using chemotherapy or radiation therapy, harvesting bone marrow from the donor and filtering it from the blood, and then, finally, the actual process of injecting the healthy stem cells into the patient’s body. After the transplant, the patient is kept under observation as they take medication to help prevent rejection of the new stem cells they have received.
Drugs included in the treatment include:
- Bone marrow stimulators: To activate the bone marrow to produce new blood cells, bone marrow stimulants such as leucine and epoetin alfa are used,
- sometimes in combination with immune suppressing drugs.
- Immunosuppressants: To prevent complications that may arise due to iron accumulation, medications can be given to help in getting rid of the excess iron. Using immunosuppressant medication can also reduce the chances of having complications brought about by the body developing antibodies to transfused blood by suppressing the immune system.
- Antibiotics: These are given to help fight infections because aplastic anaemia weakens the immune system leaving the patient vulnerable to infections.
Bone marrow transplant is a treatment option for various life-threatening illnesses including blood cancers like leukaemia and genetic disorders like sickle cell disease.
Treating Aplastic Anaemia
There is no specific measures you can take to prevent aplastic anaemia. However, you can take the necessary steps to reduce your risk of developing this disease.
- Avoiding exposure to herbicides, insecticides, paint removers, organic solvents and toxic chemicals like benzene.
- Avoiding exposure to radiation, especially if you work in an environment where you are likely to be exposed to it.
- Avoiding the taking of drugs like nonsteroidal anti-inflammatory phenylbutazone that can put you at a higher risk of getting this disease.
- Getting timely treatment for autoimmune disorders that can increase aplastic anaemia risk.
- Preventing infections like HIV and hepatitis which weaken the immune system and make you susceptible to aplastic anaemia.
Bone marrow transplant is a very delicate procedure that involves isolating the patient as they go through treatment, to protect them from infection, which during the treatment period, they are very vulnerable to. Bone marrow transplants should only be done using advanced equipment and be carried out by qualified specialists.