Aplastic anemia

Aplastic anemia is a blood disorder that occurs when the bone marrow stops producing new blood cells, both red blood cells, white blood cells, and platelets. In the human body, blood cells have different roles. Red blood cells act as carriers of oxygen throughout the body, white blood cells work against infections, while platelets function to prevent bleeding.
Aplastic anemia is a rare disease that can occur in men and women of all ages. However, this disorder is more common in adults in their 20s and elderly who live in developing countries, including Indonesia. Someone who has aplastic anemia often feels weak, lacks strength, and is at risk of excessive infection and bleeding.

Aplastic anemia can occur gradually in a matter of weeks and months. This condition can also appear suddenly. If aplastic anemia occurs in someone with very low blood levels, this condition can be fatal and life threatening.

Based on the cause, aplastic anemia is divided into two types, namely:

•     Hereditary aplastic anemia. This condition is caused by genetic disorders which are more common in children and adolescents. Patients with this disease are also at risk of developing other diseases, such as leukemia.
•     Aplastic anemia is not hereditary. This condition often occurs in adults because of a compromised immune system. The disorder can be caused by radiation or chemotherapy in the treatment of cancer, chemical poisons, the HIV virus or Epstein-Barr, or because of the influence of certain medications.

Symptoms of aplastic anemia

Symptoms of aplastic anemia depend on the type of blood cell which is low in level. If the red blood cells are low, a person will have difficulty breathing, fatigue, dizziness, headaches, chest pain, irregular heartbeat, and the face will turn pale.

If the white blood cells are low, a person will easily experience infection and fever. If the platelets are below normal, a person will easily experience bleeding, bruising, skin rashes, nosebleeds, and bleeding gums.
Causes of Aplastic Anemia
Aplastic anemia occurs due to damage to the bone marrow, causing blood cell production to slow or decrease. This damage is very dangerous because the bone marrow plays a major role in producing stem cells (stem cells) that produce red blood cells, white blood cells, and platelets.

There are several factors that can cause bone marrow damage, including:

•     Autoimmune disorders. This disorder causes the immune system to attack healthy cells, including stem cells that are inside the bone marrow.
•     Radiation and chemotherapy. These two types of treatment aim to kill cancer cells. But sometimes this treatment also helps damage healthy cells.
•     Virus infection. Aplastic anemia can occur due to the influence of several types of viruses, such as hepatitis, Epstein-Barr, cytomegalovirus, parvovirus B19, and HIV.
•     The use of certain drugs. Aplastic anemia can be influenced by several types of antibiotics and drugs to treat rheumatoid arthritis.
•     Exposure to chemical poisons. Exposure to chemical poisons that are often used on pesticides and insecticides can trigger aplastic anemia, especially if the exposure occurs continuously.
•     Pregnancy In pregnant women, aplastic anemia can arise due to the influence of autoimmune disorders, where the immune system in the body will attack the bone marrow during pregnancy.

Diagnosis of aplastic anemia
The doctor will diagnose aplastic anemia through a physical examination, symptoms experienced, and a review of the patient's family health history. In addition, the doctor will do a blood test and a bone marrow biopsy.

The following explanation:

•     Blood test. Under normal conditions, levels of red blood cells, white blood cells and platelets are at a certain threshold. Someone suspected of having aplastic anemia if one or all three blood cells are below the normal limit.
•     Bone marrow biopsy. At this stage, the doctor will take a bone marrow sample from the pelvis to be examined under a microscope. Bone marrow with aplastic anemia contains only a few blood cells.

Treatment of aplastic anemia
The type of treatment for aplastic anemia depends on the patient's condition and severity. The following are the types of treatment for aplastic anemia:

•     Antibiotic drugs. People with aplastic anemia often have difficulty fighting bacteria or viruses due to low white blood cell levels. In addition, aplastic anemia makes a person's immune system very weak. Antibiotic drugs are needed to prevent or treat infections so that infections do not get worse.
•     Blood transfusion. This method is used to control bleeding, reduce symptoms that appear, and supply blood cells that cannot be produced by bone marrow, so that blood cell levels return to normal. This treatment risks causing an increase in iron levels in the blood and can interfere with the function of several organs of the body.
•     Stem cell transplantation. In this method, the doctor will transplant healthy stem cells from the donor to be given to patients with aplastic anemia through an infusion. However, this treatment does not always run smoothly. In some cases, the patient's body rejects stem cells grafted from the donor. If left unchecked, this condition can cause dangerous complications.
•     Immunosuppressants. This method aims to control the activity of the immune system that damages stem cells by using drugs, such as cyclosporine or corticosteroids. Generally, this method is done if a person with aplastic anemia cannot be treated with stem cell transplantation methods.
•     Bone marrow stimulants. So that the bone marrow can re-produce new blood cells, doctors can provide stimulant drugs such as sargramostim, filgrastim, pegfilgrastim, and epoetin alfa. This method is often combined with immunosuppressants.

Prevention of aplastic anemia
Some of the steps below can be done to prevent the symptoms of aplastic anemia from getting worse:

•     Wash your hands regularly, especially after doing outdoor activities.
•     Reducing strenuous exercise to reduce the risk of bleeding due to physical contact.
•     Get enough rest if necessary.
•     Avoiding the general public so that they are not easily infected by diseases.

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