|Other encyclopedia topics:||A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9|
|Contents of this page:|
Alternative Names Return to topAnemia - secondary aplastic; Acquired aplastic anemia
Definition Return to top
Secondary aplastic anemia is a failure of the bone marrow to make enough blood cells. All blood cell types are affected.
Causes Return to top
Secondary aplastic anemia is caused by injury to blood stem cells. Normal blood stem cells divide and turn into all blood cell types, mainly white blood cells, red blood cells, and platelets. When blood stem cells are injured, there is a reduction in all blood cell types.
This condition can be caused by:
When the cause is unknown, it is referred to as idiopathic aplastic anemia. In about half of all cases, no cause can be found.
The disease may be acute or chronic.
Symptoms Return to top
Exams and Tests Return to top
Tests may include:
Treatment Return to top
In secondary aplastic anemia, removing the cause is critical. In some cases it can lead to recovery.
Mild cases of aplastic anemia may be treated with supportive care, or may not need treatment. Blood and platelet transfusions will help correct the abnormal blood counts and relieve some symptoms in moderate cases.
Severe aplastic anemia, which causes a very low blood-cell count, is a life-threatening condition. Younger patients with a severe case of the disease will need a bone marrow transplant. Older patients, or those who do not have a matched bone marrow donor, can be treated with medications that suppress the immune system, such as antithymocyte globulin (ATG), tacrolimus, or cyclosporine.
ATG consists of antibodies made in horses or rabbits against a type of white blood cell in humans called T cells. It is used to suppress the body's immune system, allowing the bone marrow to start generating blood cells again. Other medications to suppress the immune system, such as cyclosporine, tacrolimus, and cyclophosphamide (Cytoxan) also may be used. Corticosteroids and androgens have been used as well.
Outlook (Prognosis) Return to top
The condition usually gets worse unless the cause is removed or the disease is treated.
Untreated severe aplastic anemia usually gets worse, eventually leading to death. Mild and moderate forms of the disease can be slower.
Bone marrow transplant has been successful in young patients. It has a long-term survival rate of approximately 80%. Older patients have a survival rate of 40 - 70% after a transplant.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if:
Prevention Return to top
Secondary aplastic anemia may be an unavoidable consequence of treatments such as chemotherapy. Avoid toxins such as benzene and arsenic, if possible.
References Return to topCastro-Malaspina H, O'Reilly RJ. Aplastic anemia and related disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 171. Update Date: 11/23/2008 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.