Getting to know Aplastic Anemia

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Paul is busy scanning the patient’s chart. Today, he and his classmates are assigned in the medical ward. As part of their learning, they are tasked to make nursing care plans, perform physical assessment and relate laboratory findings with their patient’s condition. It may seem like a lot of work, but he isn’t complaining as he understands that this is all part of the learning process and actually, he finds it easier to understand concepts when they are applied in the real setting. He copies everything from the doctor’s orders, medical and health history, due medications and procedures.

He flips through the pages and comes into the page where laboratory findings are pasted. Urinalysis, CBC, etc. As he was looking at the CBC result, a thought comes into his mind.

“What if the body stops producing new blood cells? What would happen to that person? Will he be able to survive?” he thinks to himself as he tries to remember the functions of blood.

What is aplastic anemia?

Aplastic anemia is a condition that occurs when your body’s bone marrow stops producing enough new blood cells. To recap, the bone marrow is a sponge-like tissue inside the bones that makes stem cells that develop into red blood cells, white blood cells, and platelets.

It’s normal for the blood cells to die. The lifespan of red blood cells is about 120 days. White blood cells live less than a day. Platelets live about 6 days. Because of this, your bone marrow must constantly make new blood cells.

Because of this inability to produce enough new blood cells in aplastic anemia since the bone marrow’s stem cells are damaged, it leaves a person feeling fatigued and with a higher risk of infections and uncontrolled bleeding and prone to a number of health problems such as irregular heartbeats called arrhythmias, an enlarged heart, heart failure, and in worst case scenarios, it can even cause death.

Also called bone marrow failure, aplastic anemia can develop at any age and may occur suddenly, or it can occur slowly and get worse over a long period of time. However, those with the following conditions may be placed at higher risk in developing aplastic anemia:

  • Treatment with high-dose radiation or chemotherapy for cancer
  • Exposure to toxic chemicals
  • The use of some prescription drugs — such as chloramphenicol, which is used to treat bacterial infections, and gold compounds used to treat rheumatoid arthritis
  • Certain blood diseases, autoimmune disorders and serious infections
  • Pregnancy, rarely

Those with aplastic anemia may experience:

  • Fatigue
  • Shortness of breath with exertion
  • Rapid or irregular heart rate
  • Pale skin
  • Frequent or prolonged infections
  • Unexplained or easy bruising
  • Nosebleeds and bleeding gums
  • Prolonged bleeding from cuts
  • Skin rash
  • Dizziness
  • Headache

Aplastic anemia may be diagnosed through certain blood tests and bone marrow biopsy. For the blood tests, the doctor may suspect aplastic anemia when red and white blood cells as well as platelet levels are very low. To confirm the diagnosis, a bone marrow biopsy is needed. Here, the doctor will use a needle to remove a small sample of bone marrow from a large bone in the body (hipbone). The bone marrow sample is then examined under a microscope to rule out other blood-related diseases. In aplastic anemia, bone marrow contains fewer blood cells than normal.

Treatments for aplastic anemia include blood transfusions (to control bleeding and relieve anemia symptoms), blood and marrow stem cell transplants (to rebuild the bone marrow with stem cells from a donor), and medicines such as Immunosuppressants, Bone marrow stimulants and Antibiotics and antivirals.

With prompt and appropriate medical attention and care, many people who have aplastic anemia can be successfully treated. Also, blood and marrow stem cell transplants may offer a cure for some people who have aplastic anemia.

Sources:

 

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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