APLASTIC

ANEMIA
Reporters:
Jaymark Guatlo
Clarissa Rubio
Alyana Saplan
Michelle Erika Mejia

Definition:

Aplastic Anemia is a rare disease cause by a

decrease in or damage to marrow stem cells,
damage to the microenvironment within the
marrow, and replacement of the marrow with
fat.
The precise etiology is unknown, but it is
hypothesized that the bodys T-cells mediate
an inappropriate attack against the bone
marrow Aplasia.
Therefore, in addition to severe anemia,
significant neutropenia and
thrombocytopenia(deficiency of platelets)
also occur.

Pathophysiology

Aplastic anemia can be congenital or

acquired, but most cases are
idiopathic ( without apparent cause).
Infections in pregnancy can be trigger
it, or it may be caused by a certain
medications, chemicals, or radiation
damage.
Agents that may produce marrow
aplasia include Benzene and benzine
derivatives.

Certain toxic materials, such as:

Inorganic Arsenic

Glycol ethers

Plutonium

Radon

Clinical Manifestation

Aplastic Anemia are often insidious.

Complications resulting from bone

marrow failure may occur before the
diagnosis is establish.

TYPICAL COMPLICATIONS AND THE

SYMPTOMS OF ANEMIA:

PURPURA

AND ALSO:
Repeated Throat Infections

Lymphadenopathy.

RETINAL BLEEDING/HEMORRHAGE
(most common)

Assessment and
Diagnostic Finding

Blood tests. Normally, red blood cell,

white blood cell and platelet levels stay
within a certain range. Your doctor may
suspect aplastic anemia when all three
of these blood cell levels are very low.

Bone marrow biopsy. To confirm a diagnosis,

you'll need to undergo a bone marrow biopsy.
In this procedure, a doctor uses a needle to
remove a small sample of bone marrow from a
large bone in your body, such as your hipbone.
The bone marrow sample is examined under a
microscope to rule out other blood-related
diseases. In aplastic anemia, bone marrow
contains fewer blood cells than normal.

Once you've received a diagnosis of

aplastic anemia, you may need additional
tests to determine an underlying cause.

Medical
Management
Bone marrow transplant (BMT)
A bone marrow transplant is a procedure
to replace damaged or destroyed bone
marrow with healthy bone marrow
stem cells.
Bone marrow is the soft, fatty tissue
inside your bones. Stem cells are
immature cells in the bone marrow that
give rise to all of your blood cells.

Peripheral blood stem cell transplantation

(PBSCT)

Peripheral blood stem cell transplantation is a new

technique in which stem cells are obtained from a
patient's blood and used in bone marrow
transplantation.

What is the value of stem cells for

transplantation?

A relatively small number of stem cells can

miraculously repopulate the whole bone marrow,
provide an endless supply of stem cells, reconstitute
the entire repertory of blood cells, and restore the
immune system.

Antithymocyte globulin (ATG)

Anti-thymocyte globulin (ATG) is an

infusion of horse or rabbit-derived
antibodies against human T cells which
is used in the prevention and treatment
of acute rejection in organ
transplantation and therapy of aplastic
anemia.

Cyclosporine

An immunosuppressive polypeptide drug

C62H111N11O12 obtained from various
imperfect fungi and used especially to
prevent rejection of organ transplants .

Nursing
Management

They should be assessed carefully for

Signs of infections and bleeding.
Specific interventions are delineated in
the sections on neutropenia and
thrombocytopenia.
Nurses must also monitor for side
effects of therapy, particularly for
hypersensitivity reaction while
administering ATG.

If patients require long term

cyclosporine therapy, they should be
monitored for long term effects
include:

Renal or Liver Function

Hypertension
Pruritus
Visual impairment
Tremors
Skin cancer

They should also be informed that the

metabolism of ATG is altered by many
other medications; thus, each new
prescription needs careful assessment
for drug to drug interactions.

Patients also need to understand the

importance of not abruptly stopping
their immunosuppressive therapy.

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