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Aplastic AnemiaOne Life Matters


Aplastic Anemia

Aplastic Anemia is a rare and life-threatening bone marrow failure disease in which the bone marrow decreases or ceases to produce blood cells. Twenty years ago, its diagnosis was a death sentence; today, bone marrow blood stem cells transplants offer hope. With proper and effective treatment, a blood stem cell transplant can replace the disease blood stem cells in the bone marrow and result in successful reproduction of blood cells. With careful medical treatment and aherence to some rigid rules for a short period of 5-6 years, and no relapses, today's Aplastic Anemia patient can be considered cured and life a long normal life.

Why "Aplastic" Anemia?

Aplastic Anemia derives its name from the process of the disease in which the blood stem cells within the bone's marrow cease to function and the cells within follicles within the marrow are replaced by fat cells. As the disease progresses, the bone marrow becomes aplastic, hence its name. Symptoms can go unnoticed until the disease has already progressed to a severe level.

No Tests for Aplastic Anemia

There is no particular test for Aplastic Anemia; rather, it is a diagnosis derived by eliminating all other possibilities for the declining blood cell production.

bone marrow produces its destruction

Aplastic Anemia results because the bone marrow fails (to do that which it is supposed to do - create blood cells). Oddly enough, the bone marrow is responsible for creating the very cells that attack the marrow. In people with Aplastic Anemia, the bone marrow becomes diseased (see causes) and produces t-cells that trigger the immune system into attacking the bone marrow. So, Aplastic Anemia can also be classified as a type of immune system disorder or disease.

Aplastic Anemia Lacks Outword Symptoms

Aplastic Anemia can also be considered one of the silent killers, like high cholesterol, because it fails to produce highly-noticable symptoms until it has progressed to one of its more severe stages.

initial presentation of the disease

Aplastic Anemia typically presents itself with declining red blood cell counts, but that is not always the first indication.

Low b-12, red blood cells, platelets

Victoria had declining B-12 levels, then declining platelet count levels before her red blood cells ever displayed a significant decline. In the early stages of the red blood cells being affect, her red blood cells were enlarged and malformed, which could have been caused by the low B-12 level. A low B-12 level can produce malformed red blood cells, which can then be depicted on a complete blood count report (called a CBC lab) as an incorrect mean corpuscular volume (MCV) level. As well, she was pregnant at the time that the low B-12 level was discovered. Pregnancy can cause low B-12 levels.

Despite the fact that she received weekly B-12 shots, her B-12 levels didn't hold. When her general practioner saw that her blood cells were malformed, and began blasting, he referred her a hemotologist.

Typically, when there is a blood disorder effected by the bone marrow, and red blood cells are malformed, burst of immature red blood cells are produced by the marrow and injected into the blood stream in response to the body's alert to a need for more red blood cells. To complicate matters more, blasts of cells such as these can indicate a form of cancer in which the blasts are the symptom.

hellp syndrome

As well, with her being pregnant, these symptoms could have indicated HELLP Syndrome, and in fact were mistaken for HELLP by one of her doctors. HELLP Syndrome produces like symptoms with declining blood levels, but corrects itself shortly after the baby is born.

At one point, her blood specialist believed that her symptoms were produced by the pregnancy, and that they would correct after the baby was born. The declining blood cell counts held for a short period of time after the baby's birth (likely due to a termendous number of transfusions during childbirth), but again began to decline.

A segment of the medical community believes that HELLP can form into Aplastic Anemia. In Victoria's case, her Aplastic Anemia specialists do not support the theory that her pregnancy caused the Aplastic Anemia.

declining blood cell counts

Aplastic Anemia presents with declining blood cell counts. Typically, red blood cell counts decline first, but that is not always the case as noted above.

Because declining red blood cell counts rarely cause other effects initially, except for fatigue, headaches and perhaps sore joints, they can be mistaken for other causes, or even as flue-like symptoms. As the blood cell counts continue to decline, brusing may occur more easily. When the white cell counts decline dramatically, infections may start. All of these symptoms can be passed-off for other issues, including a cold or influenza.


When the platelet levels decline to nearly critical levels, dermatologic symptoms appear iwth purple dots or spots on the skin called Purpura. These spots are actually blood cells that have burst. Bruising may occur with no cause or minimal pressure on the skin.

Throughout its progression, Aplastic Anemia patients report excessive daily fatigue of a greater magnitude than can be imagined.

clinically defining aplastic anemia

Aplastic Anemia is classified by its severity: mild, severe, very severe. Severe Aplastic Anemia is defined as follows:

Bone marrow cellularity < 25%, or marrow cellularity < 50% but with < 30% residual hematopoietic cells.

Two out of three of the following (in peripheral blood): neutrophils < 0.5 x 10^9/L; platelets < 20 x 10^9/L; reticulocytes < 20 x 10^9/L. SAA diagnostic criteria may be applied to assessment at initial diagnosis or to the follow-up assessments.

aplastic anemia Information:

For more information about Aplastic Anemia, please consider these sites:

Aplastic Anemia Association

One Life Matters BLOG


Bone Marrow Donation

Bone Marrow Testing


While it is far from a blessing that Victoria has been diagnosed with Aplastic Anemia, there have been so many blessings along the road to that diagnosis. The elimination of Leukemia, Lymphoma and MDS was a blessing. Her brother and sister both being excellent matches is a blessing. Having a sibling donor and eliminating the need for radiation is a blessing. Her doctors' affirmative confirmation that it is Aplastic Anemia and not one of the other diseases often producing like symptoms is a blessing. Even the fact that her levels fell quickly is a blessing; they have been hovering at seriously low levels making her more susceptible to infections, which has been a more serious situation than being able to receive a corrective treatment.