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What is Aplastic Anemia? Causes, Symptoms and Treatment Options

Brooke Phillips, CWCMS
Editor | Shield HealthCare
12/03/13  12:34 AM PST
Smiling Asian American family

Aplastic anemia is a very rare bone marrow failure disease. Bone marrow – the spongy tissue inside bones – is responsible for makes the three basic types of blood cells: red cells, white cells and platelets. In aplastic anemia, the bone marrow stops making enough blood cells to meet the body’s needs. There is nothing wrong with the blood cells the bone marrow does make, however the quantity of blood cells is much lower than normal.  Although the exact cause of the condition is frequently not known, most cases of severe aplastic anemia are believed to be caused by autoimmune disorders which trigger the body’s immune system to attack its own tissues and organs.

Approximately 600 to 900 people in the U.S. are diagnosed with aplastic anemia each year.  It is most often diagnosed in children and young adults, although it can develop in anyone at any age.  The condition can be moderate, severe or very severe. Severe aplastic anemia is a serious disorder that requires immediate medical attention.  Blood cells are critical to supplying oxygen and nourishment to our tissues and organs, fighting off infection and clotting the blood. People with severe or very severe aplastic anemia are at high risk for life-threatening infections or bleeding.


Aplastic anemia is caused by destruction of the stem cells in bone marrow that create red blood cells, white blood cells and platelets. Although some environmental factors have been identified as triggers of the body’s autoimmune response, in most cases the stem cell destruction is believed to be caused by an existing autoimmune disorder.

Aplastic anemia can be acquired (there is no family history and the exact cause is not known) or hereditary.

About 25% of acquired aplastic anemia cases may be linked to environmental factors. These include:

  • Toxins, such as pesticides, arsenic, and benzene
  • Radiation and chemotherapy used to treat cancer
  • Treatments for other autoimmune diseases, such as lupus and rheumatoid arthritis
  • Pregnancy


The symptoms of aplastic anemia are caused by low blood cell counts. The symptoms depend on which type of blood cell is most affected.

Low red blood cell count symptoms (anemia)

Red blood cells carry oxygen from the lungs to the rest of the body. Symptoms of a low red blood cell count include:

  • Significant fatigue
  • Difficulty feeling alert, having trouble concentrating
  • Appetite loss or weight loss
  • Paler-than-normal skin
  • Difficulty breathing, shortness of breath
  • Rapid heartbeat
  • Reduced ability to exercise or climb stairs

Low white blood cell count (neutropenia)

White blood cells fight infections in the body by attacking and killing bacteria and viruses. Symptoms of a low white blood cell count include:

  • Bladder infections that make it painful to pass urine, or make you urinate frequently
  • Lung infections that cause coughing and difficulty breathing
  • Sinus infections and a stuffy nose
  • Skin infections
  • Recurring fevers
  • Mouth sores

Low platelet count (thrombocytopenia)

Platelets help our blood to clot and stops bleeding. Symptoms of a low platelet count include:

  • Easy bruising or bleeding, even from minor scrapes and bumps
  • Heavy menstrual periods
  • Nose bleeds
  • Small red spots under the skin, caused by bleeding
  • Bleeding gums, especially after dental work or from brushing your teeth

Treatment Options

Although aplastic anemia is not a cancer, some treatment options for the condition are similar to therapies used for blood-forming cancers, such as leukemias and lymphomas. For this reason, aplastic anemia may be treated in a cancer center. Depending on how severe the aplastic anemia is, your doctor may use any combination of treatment options, including:

  • High-dose cyclophosphamide (chemotherapy)
  • Bone marrow and stem cell transplantation
  • Immunosuppressive drug therapy
  • Blood transfusions and antibiotics

People with aplastic anemia are also at higher risk for complications during and after surgery, throughout pregnancy and childbirth, and when traveling by airplane or at high altitudes.

For more information about aplastic anemia, visit the Aplastic Anemia & MDS International Foundation, Mayo Clinic and Johns Hopkins Medicine, which provided source information for this article.

This article is designed for educational use only and does not replace the advice of a medical professional. If you are concerned about symptoms of aplastic anemia in you or a loved one, please contact your primary care physician.