Aplastic Anemia

Aplastic Anemia questions and answers

Learn About Aplastic Anemia Treatment Strategies.

Q: Aplastic Anemia?
I have aplastic anemia and I was wondering if there was anyone is aplastic, or who knows anyone who is aplastic?

A: hi! i also had aplastic anemia...i got a bone marrow transplant in 2006 and it worked!.....but i didnt get graft vs host disease about 6 months after my transplant...and that has been absolute hell! ive still got it and its still very horrible lol...its only on my skin though, im lucky its not in one of my organs or something! my name is sarah, im 19 and i live in Ballina, N.S.W, Australia. How bout u?

Q: Aplastic anemia?
We have a friend that has been diagnosed with aplastic anemia and none of the doctors can figure out how he got it. They will not do any research at the moment, they said that if there was 150 people with they would start it right away, but not for one. Other people have had it, more will get it, why not prevent it? Does anybody know anything about it? Causes? He can't think of a way that he could've gotten it.

A: If you have anemia, people may say you have tired blood. That's because anemia — a condition in which there aren't enough healthy red blood cells to carry adequate oxygen to your tissues — can make you feel tired. There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. Anemia is a common blood disorder. Women and people with chronic diseases are at increased risk of the condition. If you suspect you have anemia, see your doctor. Anemia can be a sign of serious illnesses. Treatments for anemia range from taking supplements to undergoing medical procedures. You may be able to prevent some types of anemia by eating a healthy, varied diet. Signs and symptoms The main symptom of most types of anemia is fatigue. Other anemia symptoms include: Weakness Pale skin A fast or irregular heartbeat Shortness of breath Chest pain Dizziness Cognitive problems Numbness or coldness in your extremities Headache Initially, anemia can be so mild it goes unnoticed. But signs and symptoms increase as the condition worsens. Causes Blood consists of both a liquid called plasma and cells. Floating within the plasma are three types of blood cells: White blood cells. These blood cells fight infection. Platelets. These blood cells help your blood clot after a cut. Red blood cells (erythrocytes). These blood cells carry oxygen from your lungs, via your bloodstream, to your brain and the other organs and tissues. Your body needs a supply of oxygenated blood to function. Oxygenated blood helps give your body its energy and your skin a healthy glow. Red blood cells contain hemoglobin — a red, iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body, and to carry carbon dioxide from other parts of the body to the lungs so that it can be exhaled. Most blood cells, including red blood cells, are produced regularly in your bone marrow — a red, spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, protein and vitamins from the foods you eat. Anemia is a state in which the number of red blood cells or the hemoglobin in them is below normal. When you're anemic, your body produces too few healthy red blood cells, loses too many of them or destroys them faster than they can be replaced. As a result, your blood is low on red blood cells to carry oxygen to your tissues — leaving you fatigued. Common types of anemia and their causes include: Iron deficiency anemia. This most common form of anemia affects about one in five women, half of pregnant women and 3 percent of men in the United States. The cause is a shortage of the element iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells. The result is iron deficiency anemia. One way your body gets needed iron is when blood cells die — the iron in them is recycled and used to produce new blood cells. So, if you lose blood, you lose iron. Women with heavy periods who lose a lot of blood each month during menstruation are at risk of iron deficiency anemia. Slow, chronic blood loss from a source within the body — such as an ulcer, a colon polyp or even colon cancer — also can lead to iron loss and iron deficiency anemia. Your body also gets iron from the foods you eat. An iron-poor diet can lead to this anemia. In pregnant women, a growing fetus can deplete the mother's store of iron, leading to iron deficiency anemia. Vitamin deficiency anemias. In addition to iron, your body needs folate and vitamin B-12 to produce sufficient numbers of healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. People who have an intestinal disorder that affects the absorption of nutrients are prone to this type of anemia. Some people are unable to absorb vitamin B-12 for a variety of reasons and develop vitamin B-12 deficiency anemia, which is sometimes called pernicious anemia. Vitamin deficiency anemias fall into a group of anemias called megaloblastic anemias, in which the bone marrow produces large, abnormal red blood cells. Anemia of chronic disease. Certain chronic diseases — such as cancer, rheumatoid arthritis, Crohn's disease and other chronic inflammatory diseases — can interfere with the production of red blood cells, resulting in chronic anemia. Kidney failure also can be a cause of anemia. The kidneys produce a hormone called erythropoietin, which stimulates your bone marrow to produce red blood cells. A shortage of erythropoietin, which can result from kidney failure or be a side effect of chemotherapy, can result in a shortage of red blood cells. Aplastic anemia. This is a life-threatening anemia caused by a decrease in the bone marrow's ability to produce all three types of blood cells — red blood cells, white blood cells and platelets. Many times, the cause of aplastic anemia is unknown, but it's believed to often be an autoimmune disease. Some factors that can be responsible for this type of anemia include chemotherapy, radiation therapy, environmental toxins, pregnancy and lupus. Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelodysplasia, a pre-leukemic condition, can cause anemia by affecting blood production in the bone marrow. The effects of these types of cancer and cancer-like disorders vary from a mild alteration in blood production to a complete, life-threatening shutdown of the blood-making process. Additionally, other cancers of the blood or bone marrow, such as multiple myeloma, myeloproliferative disorders and lymphoma, can cause anemia. Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases can cause increased red blood cell destruction. Autoimmune disorders can cause your body to produce antibodies to red blood cells, destroying them prematurely. Certain medications, such as some antibiotics used to treat infections, also can break down red blood cells. Hemolytic anemias may cause yellowing of the skin (jaundice) and an enlarged spleen. Sickle cell anemia. This inherited and sometimes serious anemia, which affects mainly people of African and Arabic descent, is caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular-shaped red blood cells die prematurely, resulting in a chronic shortage of red blood cells. Sickle-shaped red blood cells can also block blood flow through small blood vessels in the body, producing other, often painful, symptoms. Other anemias. There are several other, rarer forms of anemia, such as thalassemia and anemias caused by defective hemoglobin. Sometimes, no cause of anemia can be identified. Risk factors These factors place you at increased risk of anemia: Poor diet. Anyone — young or old — whose diet is consistently low in iron and vitamins, especially folate, is at risk of anemia. Your body needs iron, protein and vitamins to produce sufficient numbers of red blood cells. Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in the small intestine — such as Crohn's disease and celiac disease — puts you at risk of anemia. Surgical removal of or surgery to the parts of the small intestine where nutrients are absorbed can lead to nutrient deficiencies and anemia. Menstruation. In general, women are at greater risk of iron deficiency anemia than are men. That's because women lose blood — and with it, iron — each month during menstruation. Pregnancy. Pregnant women are at an increased risk of iron deficiency anemia because their iron stores have to serve the increased blood volume of the mother as well as be a source of hemoglobin for the growing fetus. Chronic conditions. For example, if you have cancer, kidney or liver failure, or another chronic condition, you may be at risk of what's called anemia of chronic disease. These conditions can lead to a shortage of red blood cells. Slow, chronic blood loss from an ulcer or other source within the body can deplete your body's store of iron, leading to iron deficiency anemia. Family history. If your family has a history of an inherited anemia, you also may be at increased risk of the condition. Certain infections, blood diseases and autoimmune disorders, exposure to toxic chemicals, and the use of some medications can affect red blood cell production and lead to anemia. Other people at risk of anemia are people with diabetes, people who are dependent on alcohol (alcohol interferes with the absorption of folic acid) and people who adhere to a strict vegetarian diet, who may not get enough iron or vitamin B-12 in their diet. When to seek medical advice See your doctor if you're feeling fatigued for unexplained reasons, especially if you're at risk of anemia. Some anemias, such as iron deficiency anemia, are common. But don't assume that if you're tired, you must be anemic. Fatigue has many causes besides anemia. Some people learn that their hemoglobin is low, which indicates anemia, when they go to donate blood. Low hemoglobin may be a temporary problem remedied by eating more iron-rich foods or taking a multivitamin containing iron. However, it may also be a warning sign of blood loss in your body that may be causing you to be deficient in iron. If you're told that you can't donate blood because of low hemoglobin, ask your doctor if you should be concerned. If you have a family history of an inherited anemia, such as sickle cell anemia, talk to your doctor and possibly a genetic counselor about your risk and what risks you may pass on to your children. Screening and diagnosis Doctors diagnose anemia with the help of a medical history, a physical exam and blood tests, including a complete blood count (CBC). This blood test measures levels of red blood cells and hemoglobin in your blood. Some of your blood may also be examined under a microscope to study the size, shape and color of your red blood cells, which may indicate a diagnosis. For example, in iron deficiency anemia, red blood cells are smaller and paler in color than normal. In vitamin deficiency anemias, red blood cells are enlarged and fewer in number. If you receive a diagnosis of anemia, your doctor may order additional tests to determine the underlying cause. For example, iron deficiency anemia can result from chronic bleeding of known or unknown ulcers, benign polyps in the colon, colon cancer, tumors, or kidney failure. Your doctor may test for these and other conditions that may underlie the anemia. Occasionally, it may be necessary to study a sample of your bone marrow to diagnose anemia. Complications When anemia is severe enough, it may interfere with your ability to do everyday tasks. You may be too exhausted to work or play. Although anemia is often treatable, it may take several weeks to months for red blood cell levels to return to normal after treatment. Ask your doctor what to expect from treatment. If you've been diagnosed with anemia — it's often detected during routine blood tests — ask your doctor what treatment is necessary. Then be sure to follow through on treatment, even if you quickly start to feel better. Left unchecked, anemia can lead to a rapid or irregular heartbeat — an arrhythmia. Your heart must pump more blood to compensate for the lack of oxygen in the blood when you're anemic. This can even lead to congestive heart failure. Untreated pernicious anemia can lead to nerve damage and decreased mental function, as vitamin B-12 is important not only for healthy red blood cells but also for optimal nerve and brain function. Some inherited anemias, such as sickle cell anemia, can be serious and lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal. Treatment Anemia treatment depends on the cause: Iron deficiency anemia. This form of anemia is treated with iron supplements, which you may need to take for several months or longer. If the underlying cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and stopped. This may involve surgery. Vitamin deficiency anemias. Pernicious anemia is treated with injections — often lifetime injections — of vitamin B-12. Folic acid deficiency anemia is treated with folic acid supplements. Anemia of chronic disease. There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. Iron supplements and vitamins generally don't help this type of anemia. However, if symptoms become severe, a blood transfusion or injections of synthetic erythropoietin, a hormone normally produced by the kidneys, may help stimulate red blood cell production and ease fatigue. Aplastic anemia. Treatment for this serious anemia may include blood transfusions to boost levels of red blood cells. You may need a bone marrow transplant if your bone marrow is diseased and can't make healthy blood cells. You may need immune-suppressing medications to lessen your immune system's response and give the transplanted bone marrow a chance to start functioning again. Anemias associated with bone marrow disease. Treatment of these various diseases can range from simple medication to chemotherapy to bone marrow transplantation. Treatment of these types of anemia usually involves a consultation from a blood specialist (hematologist). Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating related infections and taking drugs that suppress your immune system, which may be attacking your red blood cells. Short courses of treatment with steroids or gamma globulin can help suppress your immune system's attack on your red blood cells. If the condition has caused an enlarged spleen, you may need to have your spleen removed. The spleen — a small organ below your rib cage on the left side — filters out and stores defective red blood cells. Certain hemolytic anemias can cause the spleen to become enlarged with damaged red blood cells. Sickle cell anemia. Treatment for this incurable anemia may include the administration of oxygen, pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent complications. Doctors also commonly use blood transfusions, folic acid supplements and antibiotics. A bone marrow transplant may be an effective treatment in some circumstances. A cancer drug called hydroxyurea (Droxia, Hydrea) also is used to treat sickle cell anemia in adults. Prevention Many types of anemia can't be prevented. However, you can help avoid iron deficiency anemia and vitamin deficiency anemias by eating a healthy, varied diet that includes foods rich in iron, folate and vitamin B-12. The best sources of iron are beef and other meats. Other foods rich in iron include beans, lentils, iron-fortified cereals, dark green leafy vegetables, dried fruit, nuts and seeds. Folate, and its synthetic form, folic acid, can be found in citrus juices and fruits, dark green leafy vegetables, legumes and fortified breakfast cereals. Vitamin B-12 is plentiful in meat and dairy products. Foods containing vitamin C, such as citrus fruits, help increase iron absorption. Eating plenty of iron-containing foods is particularly important for people who have high iron requirements, such as children — iron is needed during growth spurts — and pregnant and menstruating women. Adequate iron intake is also crucial for infants, strict vegetarians and long-distance runners. Doctors may prescribe iron supplements or multivitamins containing iron for people with high iron requirements. But iron supplements are appropriate only when you need more iron than a balanced diet can provide. Don't assume that if you're tired that you simply need to take iron supplements. Overloading your body with iron can be dangerous.

Q: Is it appropriate to take iron supplemets for aplastic anemia?
A family member has aplastic anemia. He was not given any type of prescription. So, he plans to purchase iron supplements. Is this acceptable for his type of anemia. I appreciate the responses.

A: Please read the full wikipedia article: http://en.wikipedia.org/wiki/Aplastic_anemia This is not like regular anemia. It is very complex, requiring very complex testing and treatment. It could be he is in the process of receiving different tests to determine the course of treatment. In one section of the article, it indicates that based upon the levels of all blood cell types, not just red blood cells, a determination of remission can be made. I believe that your relative needs to receive a complete description of his disease, his prognosis, his treatments, and where he is in his testing/treatment right now. I mean, are they waiting for more test results or to see if he improves before beginning a next treatment, or even the first one? It appears to be a serious disease, and I would hope that all of his questions are being answered by his doctor, and that he is not wondering about any of his possible treatments. They should be being administered by his doctor under supervision, and he should not, it appears, be medicating himself for this rather complicated and potentially life threatening disease. If his current doctor is incapable of answering his questions, and fully explaining the course of his disease and treatment, then he needs to see another doctor immediately, and I would suggest a hematologist (a doctor specializing in blood disorders). Good luck.

Q: Can Marijuana help with either the side effects of aplastic anemia or even help prevent it altogether?
Can marijuana help with either the side effects of aplastic anemia or even help prevent it altogether?

A: Marijuana isn't going to do anything but just harm your lungs, as you probably may already know, aplastic anemia means your bone marrow isn't producing enough red blood cells. So cannabis just isn't going to do crap.

Q: aplastic anemia?
Does anybody have this condition? i do and im 19yrs old from australia and ive had a bone marrow transplant...ide like to chat with sumbody that also has aa.

A: sorry i dont have it ,but i am glad u were able to overcome the condition and replace your dead bone marrow with a transplant ,best of wishes for you and hope your life quality has improved after it

Q: can people with Aplastic anemia drink wine?
I had Aplastic anemia ever since i was young and I am just wondering if it will make me sick and is there cure?

A: You can drink some, but in small amounts, don't get drunk off it. You will be fine if you drink in small amounts Treating immune-mediated aplastic anemia involves suppression of the immune system, an effect achieved by daily medicine intake, or, in more severe cases, a bone marrow transplant, a potential cure but a risky procedure. The transplanted bone marrow replaces the failing bone marrow cells with new ones from a matching donor. The pluripotent stem cells in the bone marrow reconstitute all three blood cell lines, giving the patient a new immune system, red blood cells, and platelets. However, besides the risk of graft failure, there is also a risk that the newly created white blood cells may attack the rest of the body.

Q: Aplastic anemia caused by spleen and bone marrow disfunction /Spleen reduction and bone marrow transplantation
17 year old boy has Aplastic anemia caused by spleen and bone marrow disfunction. And doctors said that he needs Spleen reduction and bone marrow transplantation. How much will it cost? and where is the best hospitals for that?

A: Any large urban medical center that has a transplant unit should be able to do it. One good one is University Of Pittsburgh Medical Center, Pittsburgh, PA. They have a transplant unit that does all kinds of organ transplants including hearts, so a bone marrow transplant done by injection should be easily possible. It requires a lengthy hospital stay for the entire procedure, so the cost will be very high. Google UPMC Medical Center, Pittsburgh,PA for numerous site given.

Q: What can you tell about me about aplastic anemia?
Can stress cause it too? This is research for a novel I'm working on. Anyone in the medical field profession would be helpful?

A: Aplastic Anemia (Severe) Aplastic anemia is a disease of the bone marrow. The bone marrow stops making enough red blood cells, white blood cells and platelets for the body. Any blood cells the marrow does make are normal, but there are not enough of them. Aplastic anemia can be moderate, severe or very severe. People with severe or very severe aplastic anemia are at risk for life-threatening infections or bleeding. On this page: Aplastic Anemia Causes, Symptoms and Diagnosis Aplastic Anemia Treatment Options Supportive Care -- Blood Transfusions, Growth Factors, Infection Prevention Immunosuppressive Therapy Bone Marrow or Cord Blood Transplant (BMT) Making Treatment Choices Aplastic Anemia Causes, Symptoms and Diagnosis Aplastic anemia is a rare disease. About 3 out of every 1 million people in the United States get aplastic anemia each year. The disease appears more often in eastern Asian countries, where it affects about 15 out of every 1 million people. It can affect people of any age. Causes The bone marrow produces all of the blood cells for the body: Red blood cells carry oxygen to all parts of your body. White blood cells help the body fight infection. Platelets help control bleeding. Each blood cell lives only a certain number of days, so the body needs a steady supply. Healthy bone marrow is always making new blood cells. However, in aplastic anemia, the marrow makes a much smaller number than normal of all three types of blood cells. In very severe cases, the marrow can stop making any blood cells at all. In most cases, doctors do not know the cause of aplastic anemia. In about 20% of patients, the disease develops from an inherited disorder, such as Fanconi anemia. Aplastic anemia may also be caused by high doses of radiation or certain chemicals or viruses. There is evidence that in many people aplastic anemia is an autoimmune disease. This means that the body's immune system is reacting against itself. The immune system attacks the bone marrow and stops it from making enough blood cells. Symptoms Symptoms of aplastic anemia are caused by low numbers of blood cells. The severity of a person's symptoms depends on the number of blood cells he or she has. Low numbers of red blood cells can cause a person to feel tired or weak, be short of breath and look pale. Low numbers of white blood cells can lead to frequent or severe infections. Low numbers of platelets can lead to easy bleeding or bruising and tiny red spots under the skin (petechiae), or bleeding that is hard to stop. For a person with moderate aplastic anemia, these symptoms may be mild or moderate. For a person with severe or very severe aplastic anemia, infections or bleeding can be life-threatening. Diagnosis To diagnose aplastic anemia, doctors look at samples of blood and bone marrow. In aplastic anemia, the numbers of red blood cells, white blood cells and platelets in the blood are all low. There are two types of samples that can be collected from the bone marrow. A bone marrow aspiration uses a needle to extract a small amount of liquid marrow. A bone marrow biopsy uses a special needle to remove an intact core of marrow. Aspirations and biopsies are both usually taken from the back of the hip bone. In aplastic anemia, the marrow samples show low numbers of cells. The few cells that do appear are normal (not cancer cells). Based on the number of cells that appear, doctors diagnose the disease as moderate, severe or very severe aplastic anemia. Moderate aplastic anemia sometimes becomes severe over time, so doctors will watch for signs the disease is changing. Aplastic Anemia Treatment Options Treatment options for aplastic anemia depend on how severe the disease is. A person with moderate aplastic anemia may not need any treatment. Instead, doctors will check blood counts regularly to watch for signs the disease is getting worse. A person with severe or very severe aplastic anemia needs treatment as soon as possible. For severe and very severe aplastic anemia, standard treatment options (all discussed further below) include: Supportive care to keep a patient stable until other treatment can begin or take effect. Immunosuppressive therapy -- drugs that suppress (weaken) the immune system. Bone marrow or cord blood transplant (also called BMT). All patients with severe aplastic anemia will need supportive care, but the only treatments that can cure the disease or manage it for the long-term are a transplant or immunosuppressive therapy. A transplant is the preferred standard treatment for many patients, while immunosuppressive therapy is the first choice for others. Research into treatment of aplastic anemia is ongoing, so other, newer treatment options may also be available. Whichever treatment you and your doctor decide on, you may choose to be part of a clinical trial. Even standard treatments continue to be studied in clinical trials. These studies help doctors improve treatments so that more patients can have better results. Supportive Care -- Blood Transfusions, Growth Factors, Infection Prevention Patients with severe or very severe aplastic anemia will need supportive care. Supportive care such as blood transfusions, growth factors and infection prevention are not a cure. However, supportive care can manage symptoms until other treatments can begin or take effect. Some people may also choose supportive care as their only treatment. People who are older or who have other health problems may be unable to tolerate stronger treatment. Other people weigh the possible risks and benefits of different treatment options and choose supportive care. Supportive care does not offer the possibility of curing or controlling severe aplastic anemia for the long-term, but it may provide a person with a higher quality of life. Blood Transfusions People with severe aplastic anemia usually need blood transfusions. Platelet transfusions reduce the risk of life-threatening bleeding caused by very low numbers of platelets. Red blood cell transfusions reduce problems with being very tired and short of breath. Transfusions are an important treatment to manage the symptoms of aplastic anemia. If you have severe aplastic anemia, your doctor will determine when you need transfusions and manage the possible risks. For patients with severe aplastic anemia, doctors try to give as few transfusions as possible to: Limit the amount of iron that builds up in the body from red blood cell transfusions. Large amounts of iron in the body cause organ damage. Patients who need many red blood cell transfusions may receive additional treatment to remove iron from the body (iron chelation therapy). Reduce risks the immune system will develop antibodies (immune cells) that attack transfused platelets. Prepare for the possibility of a transplant. For patients treated with transplant, having many transfusions increases transplant risks. In addition, it is common to treat the blood with radiation and to filter the white blood cells out of the blood before it is given in a transfusion. These steps help reduce the risks of an immune system reaction against transfused platelets and risks of a potential transplant, as well as risks of other possible complications. If there is any chance a patient may receive a transplant, the doctor will avoid giving the patient blood donated by a family member. If that family member is later found to be a suitable donor for a transplant, the patient's immune system may react against the transplant. Growth Factors Growth factors are drugs that help the body make more blood cells. A person with aplastic anemia may be given growth factors to try to reduce the need for red blood cell transfusions. However, in many cases of aplastic anemia, the marrow does not respond to growth factors. Growth factors may also be given after treatment with immunosuppressive therapy or transplant. In this case, growth factors often are effective. They can help speed up new blood cell production, reducing a person's need for transfusions and reducing infection risks. Infection Prevention People with severe aplastic anemia are at risk for life-threatening infections. Even a common infection like a cold could become serious. To help prevent infection, people with severe aplastic anemia need to protect themselves from germs. Steps to take may include avoiding crowds and sick people. If you have severe aplastic anemia, talk with your doctor about how you can reduce your risk of infection. If a fever or other signs of infection appear, the infection must be treated quickly. The most common treatment for infection is antibiotics. Immunosuppressive Therapy Immunosuppressive therapy is one of two standard treatments that have the potential to offer a person with severe aplastic anemia a longer life. The other treatment, a transplant, is often recommended as the first treatment for children and young adults with a suitable sibling donor. Immunosuppressive therapy is often recommended as the first treatment for patients who: Are older than age 40, though recommendations based on age vary among doctors and with other patient factors. Are unable to tolerate a transplant because of other health problems or older age. Do not have a suitable donor or cord blood unit for transplant. Will be treated with transplant, but are waiting for a suitable donor to be found. Choose immunosuppressive therapy after weighing the potential risks and benefits of all options. The immune system is made up of organs and cells that work together to protect the body from infection and disease. The immune system uses white blood cells to fight infections. The white blood cells mark and attack cells that they do not recognize as belonging in the body. Immunosuppressive therapy uses drugs that suppress (weaken) the immune system. This treatment is based on the widely accepted theory that aplastic anemia is a result of the immune system attacking the bone marrow. Immunosuppressive therapy weakens the immune system's response and allows the marrow to make more blood cells. For many people, immunosuppressive therapy raises blood counts to normal or near normal levels and leads to long-term survival. Immunosuppressive therapy has few short-term risks. However, people often must repeat or continue therapy for the long term. The therapy also increases the risks of getting a second disease such as myelodysplastic syndrome (MDS) or leukemia later on. To learn more about immunosuppressive therapy drugs and treatment results, see Immunosuppressive Therapy for Aplastic Anemia. Bone Marrow or Cord Blood Transplant (BMT) For many patients with severe or very severe aplastic anemia, a marrow or cord blood transplant is the preferred standard treatment. A transplant replaces the abnormal cells in the bone marrow with healthy blood-forming cells from a family member or unrelated donor or cord blood unit. The donor for a transplant must closely match the patient's tissue type. The best donor is usually a matched sibling. For patients who do not have a suitable donor in their family, doctors may search the National Marrow Donor Program (NMDP) Registry for a matching adult volunteer donor or cord blood unit. A transplant can offer the best chance for a cure of aplastic anemia, but it is not an option for all patients. A transplant may be a good option for patients who have a suitable donor or cord blood unit and are healthy enough to tolerate a transplant. Children and young adults tend to do better than older patients, but advances in transplant have enabled more older patients to undergo a transplant successfully. Transplants for aplastic anemia can have serious risks. However, doctors have developed treatment methods to address many of these risks and transplant outcomes have improved in the last decade. One risk that is greater for patients with aplastic anemia than for many other diseases is graft rejection or graft failure (when the transplanted cells do not grow and make blood cells for the body). Having many transfusions increases the risk of graft rejection because the patient's immune system may develop antibodies that can react against the transplanted cells. Today, doctors give aplastic anemia patients as few transfusions as possible. The transfused blood is also commonly treated with radiation and filtered to remove the white blood cells. These practices have improved transplant outcomes. Another serious risk of transplant for patients with aplastic anemia is graft-versus-host disease (GVHD). This is a common transplant complication that can range from mild to severe. For patients who receive a transplant to treat leukemia or another cancer, GVHD may be associated with a beneficial graft-versus-leukemia effect. However, there is no benefit to GVHD for patients with aplastic anemia. Advances in the treatment of GVHD have reduced this risk, but doctors continue to search for better treatments. If transplant is an option for you, your doctor can talk with you about the possible risks and benefits of a transplant. For statistics showing patients' results after transplant, see Severe Aplastic Anemia Transplant Outcomes. Making Treatment Choices If you or your child has severe aplastic anemia, it is important to see a doctor who is an expert in the disease. If your doctor has not treated other patients with aplastic anemia, ask him or her to refer you to an expert for consultation. A doctor who is an expert in aplastic anemia can talk with you about your treatment options and explain the possible risks and benefits. Whatever treatment you and your doctor decide on, you may choose to be part of a clinical trial. Clinical trials help doctors gain knowledge that can improve treatments for patients in the future. Even standard treatments continue to be studied in clinical trials. The two standard treatments, immunosuppressive therapy and transplant, have similar long-term survival rates for some groups of patients. Both treatments have potential risks and side effects: A transplant has higher risks of life-threatening side effects early after treatment, but a transplant can bring a long-term cure. Immunosuppressive therapy has fewer early risks, but most people are not cured and need treatment for the long term. Both treatments have some risks of long-term side effects or complications. The possible risks and benefits of these treatments vary from one person to another, depending on age and other health factors. Many doctors recommend a transplant for patients age 20 or younger, especially those who have a suitably matched sibling donor. Doctors also recommend a transplant for many patients between age 20 and 40 who have a suitable sibling donor. For patients older than age 40 and those who do not have a suitable sibling donor, many doctors recommend trying immunosuppressive therapy first. However, age is only one of the factors to look at when making treatment choices. If a patient does not respond to immunosuppressive therapy within three to four months, a transplant using either a sibling or an unrelated donor or cord blood unit may be an option. The time between diagnosis and transplant can affect transplant outcomes. To improve your chances of a successful transplant, you and your doctor can plan ahead. A consultation with a transplant doctor can help determine whether a transplant is a good option for you, either as the first treatment of choice or as a second treatment if immunosuppressive therapy fails. Even if you begin treatment with immunosuppressive therapy, your doctor can take steps to be prepared if immunosuppressive therapy does not give you good results. Your doctor can check whether you have any possible donors in your family. He or she can also search the National Marrow Donor Program Registry for potential unrelated volunteer donors or cord blood units. That way, if you and your doctor decide you need a transplant later, the first steps of the donor search will be done and you may be able to move to transplant more quickly. Information to Share with Your Doctor The Physician Resources section of this Web site includes information for doctors about planning for transplantation. You may want to share some of this information with your doctor. Referring a Patient for Transplant Effective Planning for Unrelated Donor Transplant More Information on Aplastic Anemia You can get further information about aplastic anemia from disease-specific organizations, such as the Aplastic Anemia & MDS International Foundation -- request an information packet at https://www.toad.net/~aafa/aplastic/disease_information/educational _material/index.php For other organizations that offer information and resources, see Organizations that Can Help: A Searchable Directory. Contributing Editors C. F. LeMaistre, M.D., Southwest Texas Methodist Hospital, San Antonio, Texas Anthony S. Stein, M.D., City of Hope National Medical Center, Duarte, Calif. Last Updated: February 2006

Q: What type of viral hepatides accounts for most cases of aplastic anemia?
And what are the demographics of the typical patient?

A: Unless something came out yesterday, there has never been an association between hepatitis and aplastic anemia. The only thing that I remember some years back was the side-effect of hepatitis A and a concurrent bacterial infection resulting in aplastic anemia, though serology proved that the hepatitis was not the cause. I'd like to know the answer to this myself (including references).

Q: Can stress be a cause to get aplastic anemia?
I've asked this yesterday and got nothing yet. So I thought I've rephrased it. Other than blood cells, can stress bring it on and cause it to happen? Any health professionals out there? I forgot to mention that this is research used for my novel.

A: Definitly No.

Q: Does anyone know of an 'aplastic anemia' support group in Brisbane, Australia?
My son has a blood disorder 'severe aplastic anemia'. I am looking for a support group around the Brisbane (Australia) area. It has been almost four years since his dionosis. I have yet to find a support group for the blood disorder. It seems that every other blood disorder has a support group. Why can I not find one for this disorder? Please, if you know of any, let me know. Preferably in Australia.

A: Ask at your local medical facility, clinic or even your Physician..I am sure that the Internet has some as well, but the Doctor is the best bet. Good Luck to you. .wikipedia.org/wiki/Aplastic_anemia..

Q: aplastic anemia, side affects later in life with pregnancy and being fertile?
my girl has aplastic anemia, she got past it. the only info her doctor gave her was saying she might have problems having children when she is older. anyone know if you are less fertile after having aplastic anemia? is that what the doctor meant, that it damaged her whole ordeal with being fertile enough to concieve?

A: Hello dear I have Aplastic Anemia and what the doctor meant it's that Aplastic Anemia "may" come back and start again when a woman is pregnant, "it depends" so the important thing is in the future when she wants to try pregnancy just start keeping an eye on the blood counts so to notice in time any changes. In case of chemotherapy for bone marrow transplant then discuss with the doctors if eggs can be removed and what is the chance later of fertility, have a look at this AA web site hope it can give you more answers a big hug to your girl and to you http://www.aplastic.org/aplastic/

Q: Was Marie Curie DIAGNOSED with aplastic anemia before her death?
I want to know if she knew of the ailment before she passed. If so, how long did she know?

A: Ms. B., under ordinary circumstances I would write the answer for you; but I am weary. My apologies for leaving only a website on which I believe that you will find the answers that you seek: http://www.aip.org/history/curie/radinst3_text.htm

Q: Any parents dealing with Aplastic Anemia?
My 7 1/2 year old son has been undergoing treatment for Aplastic Anemia for the past 6 months. I need to know that there is a light at the end of the tunnel. Has anyone been through this? I have been dealing with this disease for over 6 months now. I now what causes it, how it is treated and the odds of him developing other conditions because of this. I am asking if anyone has ever been through it, and may have an encouraging story, to help me get through this hell.

A: Hello, I personally don't have any experience with aplastic anemia, but 6 months ago I met at the daycare where I was working a boy who is currently 9 years old who suffered from Aplastic Anemia when he was 2 years old. I had the chance to speak to his mom and she told me that at that time he couldnt have the traditional therapy a patient like him was supposed to have ( i think it was a bone marrow transplant, but i am not 100% sure) so he got this therapy with steroids if i dont remember wrong he got a couple of years of this therapy, and ... well.. right now he is 9 and accoording to his mother (and what i could see!) he is doing wonderfully!! So.. yes, there is light at the end of the tunnel!!! just ask God and he will listen to you! (sorry i cant' be more helpful but that is all i can remember for now).

Q: Aplastic Anemia and bone marrow transplant?
Hi my name is Sarah, im 19, live in Ballina Australia, and im trying to find anyone that has had aplastic anemia and a bone marrow transplant like me!

A: http://www.bmtinfonet.org/services.html That site can help link you with other people. You can request a 'mentor' by age, gender, disease, and type of transplant. I had my transplant last year at 23 for leukemia using cord blood. They helped match me with a couple of diff people and it was great. Your hemonc docs may be able to help link you with others as well