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Aplastic Anemia


What Is Aplastic Anemia?

Aplastic anemia happens when the body can't make enough blood cells. The main types of blood cells are red blood cells, white blood cells, and platelets. These cells are made in the bone marrow, the spongy part inside bones. They all have important jobs:

  • Red blood cells carry oxygen from the lungs to all body parts.
  • White blood cells find and fight invading germs, such as viruses and bacteria that cause infections.
  • Platelets stop bleeding.

Without enough blood cells, a person can develop anemia, infections, and bleeding. Treatments can help with most kinds of aplastic anemia.

What Are the Signs & Symptoms of Aplastic Anemia?

Symptoms of aplastic (ay-PLASS-tik) anemia can range from mild to very severe.

  • Someone with anemia might:
    • look pale
    • have fast breathing
    • be short of breath
    • be very tired
  • Too few white blood cells leads to many infections.
  • Not enough platelets can cause:
    • nosebleeds
    • bleeding from the gums
    • blood in the poop (stool)
    • easy bruising
    • small red or purple spots on the skin called petechiae (peh-TEE-kee-eye)
    • in girls, very heavy periods 

What Causes Aplastic Anemia?

Aplastic anemia is caused by damage to stem cells. Stem cells are in the bone marrow. They develop into red blood cells, white blood cells, and platelets. These cells can't be made properly if there aren't enough stem cells.

Doctors don't always know what damages the stem cells and causes aplastic anemia. It can be from:

  • autoimmune problems, when the immune system attacks the stem cells 
  • a viral infection, such as hepatitis or Epstein-Barr virus (EBV)
  • medicines, such as:
    • anti-cancer medicines (chemotherapy)
    • antibiotics
    • anti-seizure medicines
  • chemicals such as bug or insect killers
  • radiation therapy
  • inherited disorders such as Fanconi syndrome and Shwachman-Diamond syndrome

How Is Aplastic Anemia Diagnosed?

Doctors usually can diagnose aplastic anemia by:

  • asking questions about symptoms
  • asking if any family members have blood problems
  • doing an exam
  • doing blood tests to:
    • look at the blood cells with a microscope
    • look for antibodies to see if the child's infection-fighting immune system is attacking the red blood cells
    • check how fast new red blood cells are being made
    • look for signs that a lot of red blood cells are being broken down
    • check for any inherited anemias that can lead to aplastic anemia, sometimes using genetic tests
  • taking a small bone marrow sample with a needle and sending it to the lab for special tests

How Is Aplastic Anemia Treated?

A hematologist (a doctor who specializes in blood problems) treats children with aplastic anemia. Treatment depends on the cause and the symptoms.

Treatments may include:

  • transfusion of red blood cells, and/or platelets through an intravenous (IV) line
  • medicines that:
    • prevent or treat infections
    • suppress the immune system (so it can't attack its own blood cells)
    • help the bone marrow make more cells
  • bone marrow transplant (also called a stem cell transplant), where healthy cells from a donor replace the bone marrow in the person with aplastic anemia

After treatment, children will go for regular testing to make sure the aplastic anemia doesn't come back.

How Can Parents Help?

Some children with aplastic anemia will need a lot of medical care and may need to stay in the hospital for a long time. Other children can be treated at home.

If your child has been diagnosed with aplastic anemia, you can help by:

  • taking your child to all doctor's appointments
  • following the doctor's recommendations
  • helping your child understand what aplastic anemia is and what treatments are needed
  • supporting your child during medical treatments
Reviewed by: Robin E. Miller, MD
Date reviewed: July 2019