Aplastic Anemia Can’t Just Be Cured With Iron Supplements | Health, Medicine and Fitness
Dear doctor: I have aplastic anemia. It’s hard to explain that to people. Most of them hear the anemia part and get stuck there. I often hear: “Just take some iron” or “My aunt had this and was cured with B12 injections.” How can I better explain it quickly?
Dear reader: How frustrating that must be for you. To put it simply for people, you could say that aplastic anemia is a bone marrow disease that results in bone marrow failure. If they’re staring at you with glassy eyes, you might want to leave it at that, but if they’re really interested, you can try a longer explanation.
Start by saying that aplastic anemia is a rare disease, diagnosed in one in 500,000 people per year. The incidence is two to three times higher in Asia. Then you can explain that the function of the bone marrow is to produce red blood cells, white blood cells, and clotting cells called platelets. The bone marrow contains specific cells, called hematopoietic stem cells, necessary for their production. With aplastic anemia, these stem cells are damaged, so all cell lines are diminished.
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Most cases of aplastic anemia are due to an attack by the body’s immune system on the bone marrow, which destroys blood-forming stem cells. The cause of this attack is unknown, but a virus, chemical, drug or mutation may be the instigator, impairing immunity so that the white blood cells see the stem cells as foreign and therefore attack them.
As the name suggests, the disease causes anemia, which is a decrease in the number of red blood cells. This can cause significant fatigue and stress on the heart, which has to pump this deficient blood to the rest of the body. Additionally, white blood cell depletion leads to an increased risk of pneumonia, urinary tract infections, and serious blood infections. When the white blood cell count is chronically low, patients are at risk of invasive fungal infections that can lead to death. In addition, the decrease in the number of platelets increases the risk of bleeding due to the decrease in the ability of blood to clot. Ultimately, mutations in the bone marrow can lead to leukemia.
The treatment of aplastic anemia depends on the severity of the disease, the age of the patient and the possible presence of other diseases. You may want to explain that due to the potential complications of the disease, treatment is much more aggressive than taking iron or vitamin B12 supplements.
In fact, the treatment with the greatest chance of success is the transplantation of hematopoietic stem cells from a donor, a difficult treatment with serious side effects. And while transplantation can result in prolonged survival, it just as often fails. This approach, which requires a matched donor, is recommended for healthy patients and those under the age of 50. Another method of treatment is to suppress the immune system’s attack on bone marrow cells. It requires a combination of drugs, which can also have significant side effects.
Perhaps this explanation will help people understand the seriousness of aplastic anemia and better understand what you are going through. If not, at least rest assured that some people understand your struggle and wish you strength and recovery.