Aplastic Anemia

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KEY POINTS

• Aplastic anemia is a rare disease in which the bone marrow does not make enough blood cells.
• Treatment depends on how severe your child’s aplastic anemia is. Treatment may include blood transfusions, bone marrow transplants, or medicines. Your child may need treatment in a hospital.
• Ask your child’s healthcare provider how to take care of your child at home, what symptoms or problems you should watch for, and what to do if your child has them.

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What is aplastic anemia?

Aplastic anemia is a rare disease in which the bone marrow does not make enough blood cells. Marrow is the soft, fatty tissue inside hard bone. Healthy bone marrow makes immature blood cells called stem cells. Stem cells normally develop into mature red blood cells, white blood cells, and platelets.

• White blood cells help fight infection.
• Red blood cells carry oxygen to the body.
• Platelets help the blood clot.

In aplastic anemia, the body stops making enough of all three types of blood cells. It is a serious disease that can be life-threatening without treatment.

What is the cause?

The exact cause of aplastic anemia is not always known but may include:

• A condition that your child has at birth
• Pesticides, arsenic, or other toxic chemicals
• Cancer that spreads to the bone marrow
• Infections such as Epstein-Barr, hepatitis, or HIV
• Treatments for cancer, lupus, or rheumatoid arthritis
• Rarely, pregnancy, in an older child or teen

What are the symptoms?

Symptoms depend on how low your child’s blood counts are.

Symptoms of low white blood cells often include symptoms of an infection such as:

• Burning during urination
• Cough or shortness of breath
• Diarrhea
• Fever and chills
• Redness, swelling, or warmth at the site of an injury
• Sore throat
• Stuffy nose
• Unusual vaginal discharge or itching

Symptoms of low red blood cells may include:

• Feeling unusually weak and tired
• Fast heartbeat
• Shortness of breath, especially with activity
• Pale skin
• Having trouble concentrating
• Unexpected weight loss

Symptoms of low platelets may include:

• Easy bruising and bleeding, from minor injuries or brushing teeth
• Frequent nosebleeds
• Heavy menstrual periods
• Tiny red spots on the skin

How is it diagnosed?

Your child’s healthcare provider will examine your child and ask about symptoms and medical history. Your child may have tests such as:

• Blood tests to count each type of blood cell and to see if the cells look normal under a microscope
• A bone marrow biopsy, which uses a needle passed through the skin into the bone marrow to take a small sample of tissue for testing

How is it treated?

Treatment depends on how severe your child’s aplastic anemia is. If it’s a mild form, your child may not need treatment. If your child has a more severe form, treatment may include:

• Regular blood transfusions to give your child healthy red blood cells
• Iron chelation therapy, which is medicine given to remove excess iron from the body caused by multiple blood transfusions
• Stem cell transplant, also called a bone marrow transplant, which use transplanted cells that grow into healthy blood-making cells
• Medicine to keep your child’s immune system from mistakenly attacking the bone marrow so that your child’s body can make enough blood cells
• Growth factor hormones to tell your child’s bone marrow to make more blood cells

Your child may need treatment in a hospital. Your child will have follow-up visits with the healthcare provider to see how well treatment is working.

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. Ask your child’s provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.