Aplastic Anemia Essay
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Aplasitc anemia is a very rare blood disorder. Sometimes, it is connected with leukemia; it could be a result from chemotherapy given to leukemia patients. In aplastic anemia, the bone marrow does not make the necessary blood cells needed in the blood; however, leukemia is when the blood cells are deformed and not working properly. Leukemia is a cancer where as aplastic anemia is not. Chemotherapy treatment for cancer can lead to the secondary condition of aplastic anemia that may cause slowing down of producing blood cells.
What are the anatomical and physiological symptoms and causes for aplastic anemia? What is the diagnosis and what treatments are available for aplastic anemia? One symptom is fatigue from being anemic. Anemia is when the red blood cells are low in the blood. The red blood cells carry the oxygen from your lungs to all parts of the body (Aplastic Anemia and MDS International Foundation, Inc. ). This will cause fatigue when the body does not get enough oxygen.
There is a little more than just low red blood count in cells in aplastic anemia.
It is when the body doesn’t produce all three different blood cells that the body has: white blood cells, red blood cells, and the platelets termed pancytopenia (Wikipedia). In aplastic anemia, it is when the bone marrow stops producing or slows down in producing these new blood cells. The white ones or leukocytes are to fight infections in the body by attacking and killing bacteria and viruses (Aplastic Anemia and MDS International Foundation, Inc. ), so with out them patients easily catch viruses.
A low white blood cell count is called neutropenia (Aplastic Anemia and MDS International Foundation, Inc. . The other is the platelets; they are for blood clots. A low platelet count is called thrombocytopenia (Aplastic Anemia and MDS International Foundation, Inc. ). A low platelet count leads to another symptom that would be uncontrolled bleeding because the body does not have the platelets to stop the bleeding. You can also causes bruising and petechiae (Wikipedia). Some of the other symptoms include shortness of breath, headache, pallor and, ultimately tachycardia and heart failure (Lippincott 508).
Bone tenderness should not be present (Mc Phee 454). The cause for aplastic anemia develops when the bone marrow is damaged or in some cases is unknown. About 75 out of 100 cases of acquired aplastic anemia are idiopathic (Aplastic Anemia MDS International Foundation, Inc. ). This means they have no known cause. Sometimes, the case can be from radiation and chemotherapy treatment used for cancer. This can destroy the healthy cells in the bone marrow leading to the secondary condition.
Some other causes for secondary condition of aplastic anemia are toxic chemicals and certain drugs, such as the chemical benzene that is found in gasoline, or with the use of certain drugs, including chloramphenicol[->0], carbamazepine[->1], felbamate[->2], phenytoin[->3], quinine[->4], and phenylbutazone[->5] (Wikipedia). Chloramphenicol treatment is followed by aplasia in less than 1 in 40,000 treatment courses, and carbamazepine aplasia is even more rare (Wikipedia). The medication for rheumatoid arthritis is connected to ones getting aplastic anemia; this would be called also a secondary condition when aplastic anemia appears.
Likewise Lupus, an autoimmune disorder, can attack the healthy stem cells. This would cause the slowing down or stopping of making the blood cells the body needs. The rest may result from immunologic factors (unconfirmed), severe disease (especially hepatitis), viral infection (especially children), or preleukemic and neoplastic infiltration of bone marrow (Lippincott 397). Therefore, to confirm a diagnosis for aplastic anemia they first take a blood sample to see if the blood count is low. If that shows up low in all the blood cells, the next step is to take a bone marrow sample or biopsy.
The bone marrow is usually taken from the large hip bone by a needle. The sample is looked at in a microscope to rule out leukemia, which the blood cells would look abnormal and would be the reason the blood cells are not working properly. However, aplastic anemia would show very little red and white blood cells in the blood stream. Some options of treatment given to patients are medications, bone marrow transplant, and blood transfusion (MayoClinic). Just recently, they have stem cell transplants. The medications are immunosuppressive combine with cyclosporine.
Maybe one of the causes is the immune system is attacking its own good blood cells, and these drugs will slow down the process. This medication treatment is usually given until the patient can get a stem cell transplant. The other medication can be used with the immunosuppressive is the growth factor. The new genetically engineered growth factor drugs help with making new white blood cells. That is really important, since the body makes a blood cell that only last for awhile, so the body is always generating new blood cells. However, aplastic anemia patients body for some reason stops this process.
The other medicines used are antibiotics either to help prevent infections or already established infection, since the immune system is weak and would not be unable to fight of a common cold. Most likely the doctor will administer them before an infection appears, so that the patient will not get an infection. Those are the medications used and if the condition doesn’t improve, the patient would await for a bone marrow transplant. The bone marrow transplant might have been the first choice, which the medication is administered until the patient can find a match donor.
The bone marrow transplant is usually a successful treatment to cure aplastic anemia in people under 55 years old (Aplastic Anemia and MDS International Foundation, Inc. ). Bone marrow transplantation from a related, matched donor can treat aplastic anemia – without recurrence- in about four out of five cases (MayoClinic). Up to half the people with matched, but unrelated, donors can expect to have successful bone marrow transplants (MayoClinic). There’s a chance that your body may reject the transplant, leading to life-threatening complications (MayoClinic). The bone marrow transplant uses a matched blood type.
When found, the donor will have surgically removed some of his or her healthy bone marrow. It is then injected intravenously in the blood to the patient. The donated bone marrow will collect to the patient’s bone marrow and help with making new blood cells; it may take two to four weeks to show the new blood cells are producing. Before they even give the aplastic patient the donated marrow, they give them chemo to get rid of the diseased marrow, and will also be administered drugs to help prevent rejection of the bone marrow. Another precaution a doctor may limit the number of blood transfusions before the operation to avoid complications.
Technology is advancing that they can use stem cells now instead of bone marrow transplant. The new stem cell transplant is taken from the bone marrow, umbilical cord, or the blood stream of the donor. They just get the stem cell from either of those places, and again like the bone marrow transplant, place the stem cell into the blood stream of the patient. The patient will be given chemo before the procedure as in the bone marrow transplant. This time the complication of the new stem cells will create an immune system that attacks the body of the donor, instead of the body rejecting as in the bone marrow transplant.
If this does occur, they also have drugs that will help combat this. The treatment of blood transfusion is not usually used because it is a treatment for fatigue. Fatigue is not a medical emergency. First, use rest to see if it alleviates the symptom. White blood cells only last a day because that is how long they last in the body. That is why the bone marrow is important in making the new cells the body needs. The other complication that blood transfusions may cause is hemorrhaging. For long term recovery, they usually need other treatment along with this procedure. Aplastic anemia is a very rare disease and affects very few people.
It is not contagious. It is more commonly diagnosed in young adults and children. It can affect any age group anytime in life and the illness might be brief, also it can come on suddenly or slowly. The symptoms vary depending on the blood cells that they are low in. The patient could have a slight case that might just be observed or to a severe case that needs treatment. A doctor should be the one to make the diagnoses and treatments. Doctors estimate that there are about 900 new cases of aplastic anemia diagnosed in the United States each year (Aplastic Anemia &MDS International Foundation, Inc. .
Patients need to be extra careful not to get an infection because the body having low white blood cell count would have a hard time combating against viruses. Steps are also taken to prevent hemorrhage: avoiding parenteral injections, suggesting the use of an electric razor, humidifying oxygen to prevent dry mucous membranes, and promoting regular bowel movement (Venes 116). Mortality for aplastic anemias with severe pancytopenia is 80% to 90% (Lippincott 507). In advancing technology today, why not consider to be a bone marrow donor that could save lives of others.