Aplastic anemia is a rare disease caused by abnormalities in the bone marrow, so that the organ cannot produce enough blood cells, be it red blood cells, white blood cells, platelets, or all three at once. This condition can be dangerous if the amount of blood that is reduced very much and does not get treatment.
Aplastic anemia can come on suddenly or develop slowly. Anyone can get this disease, both men and women. However, aplastic anemia is more common in adolescents, young adults in their early 20s, and the elderly.
Causes of Aplastic Anemia
Based on the cause, there are two types of aplastic anemia, namely:
Acquired aplastic anemia
This type of aplastic anemia is aplastic anemia that occurs after a person is born (not inherited from parents). This type of aplastic anemia is more common in adults.
Most cases of acquired aplastic anemia have no known cause. However, there is a theory that suggests that this condition is mostly caused by autoimmune disorders. Autoimmune disorders occur when the body's immune system mistakenly attacks a healthy organ, which in this case is the bone marrow.
Based on several studies, it is known that aplastic anemia that is acquired after birth is more at risk for people who have the following risk factors:
- Viral infections, such as hepatitis B, HIV, cytomegalovirus (CMV), and Epstein-Barr virus.
- Side effects of certain medications, such as chemotherapy for cancer and other drugs, such as antibiotics, anticonvulsants, NSAIDs, and acetazolamide.
- Exposure to chemicals or toxins, such as heavy metals, benzene (gasoline), pesticides, and insecticides.
- Frequent exposure to high-energy radiation or having undergone radiation therapy.
- Pregnancy.
Congenital aplastic anemia (iinherited aplastic anemia)
Congenital aplastic anemia is caused by a genetic disorder that is inherited from parents. This disease is most common in children and adolescents. People with this type of aplastic anemia are at risk for certain cancers, such as leukemia.
Symptoms of Aplastic Anemia
People who suffer from aplastic anemia will show symptoms according to the type of blood that is reduced in number. But in general, people with aplastic anemia can show the following symptoms:
- Easy bruising or bruising
- Wounds are hard to heal
- Fatigue
- Hard to breathe
- Dizzy
- pale skin
- Headache
- Chest pain
- pounding chest
- Easy to get infection and fever
- Frequent bleeding (eg nosebleeds, easy bruising or bruising, bleeding gums, and bloody stools)
Diagnosis of Aplastic Anemia
If you experience some of the symptoms above, immediately consult a doctor. If the doctor suspects that these complaints and symptoms are caused by aplastic anemia, you will likely be referred to a hematologist who specializes in blood-related diseases.
To determine the diagnosis and look for the cause of your aplastic anemia, the doctor will perform a physical examination and suggest supporting tests which include a complete blood test, bone marrow biopsy, liver and kidney function tests, and genetic tests.
After the test results come out, the doctor will determine whether the patient has aplastic anemia or not. If the patient is proven to have aplastic anemia, the doctor will provide treatment according to the severity of the disease and the patient's general condition.
Treatment for Aplastic Anemia
To treat aplastic anemia, doctors can take the following steps:
1. Blood transfusion
Blood transfusions cannot cure aplastic anemia, but they can relieve the symptoms of anemia and provide blood cells that the bone marrow cannot produce.
Patients with severe aplastic anemia may require repeated blood transfusions. This can increase the risk of complications of blood transfusions, such as infection, immune reaction to the donated blood, to a buildup of iron in red blood cells (hemochromatosis).
2. Cell transplant induk
Stem cell transplantation, also known as stem cell transplantation or stem cell transplantation, aims to rebuild the bone marrow with stem cells from a donor. This treatment method is still considered the only treatment option for patients with severe aplastic anemia.
Stem cell transplantation is generally done for people who are young and have a match with a donor (usually a sibling). This method can be done through a bone marrow transplant.
Although it is the main therapy option for treating aplastic anemia, this procedure of stem cell transplantation or bone marrow transplantation also has risks, namely rejection of the bone marrow from the donor.
3. Drugs that suppress the immune system (immunosuppressants)
This drug works by weakening the immune system. This treatment is usually reserved for people who cannot undergo a bone marrow transplant because they have an autoimmune disorder.
Immunosuppressants can suppress the activity of immune cells that damage the bone marrow, thereby helping the bone marrow to recover and produce new blood cells.
In treating aplastic anemia, usually these immune system-suppressing drugs are given together with corticosteroid drugs.
4. Bone marrow stimulant
Certain drugs such as sargramostim, filgrastim and pegfilgrastim, and epoetin alfa can also be used to stimulate the bone marrow to produce new blood cells. This class of drugs can be used together with immunosuppressant drugs.
5. Antibiotics and antivirals
Aplastic anemia can weaken the immune system due to the number of white blood cells that become less. This makes people with aplastic anemia susceptible to infection. To prevent infection, doctors can give antibiotics or antivirals depending on the cause of the infection.
Aplastic anemia caused by radiation exposure and chemotherapy will usually improve after treatment is complete. If it is caused by a side effect of certain drugs, then this condition will disappear after treatment is stopped.
If you have aplastic anemia, avoid sports or strenuous physical activities that are prone to injury and bleeding. In addition, wash your hands more often, vaccinate every year according to doctor's recommendations, and avoid being in crowds to reduce the risk of contracting infection.
If you have symptoms of aplastic anemia or are undergoing treatment for aplastic anemia, don't forget to consult your doctor regularly to get the right treatment and according to your condition.