Learn About Aplastic Anemia

What is the definition of Aplastic Anemia?

Aplastic anemia is a condition in which the bone marrow does not make enough blood cells. Bone marrow is the soft, tissue in the center of bones that is responsible for producing blood cells and platelets.

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What are the alternative names for Aplastic Anemia?

Hypoplastic anemia; Bone marrow failure - aplastic anemia

What are the causes of Aplastic Anemia?

Aplastic anemia results from damage to the blood stem cells. Stem cells are immature cells in the bone marrow that give rise to all blood cell types (red blood cells, white blood cells, and platelets). Injury to the stem cells leads to a decrease in the number of these blood cell types.

Aplastic anemia can be caused by:

  • Use of certain drugs or exposure to toxic chemicals (such as chloramphenicol, benzene)
  • Exposure to radiation or chemotherapy
  • Autoimmune disorders
  • Pregnancy
  • Viruses

Sometimes, the cause is unknown. In this case, the disorder is called idiopathic aplastic anemia.

What are the symptoms of Aplastic Anemia?

Symptoms are due to the underproduction of red cells, white cells, and platelets. Symptoms may be severe from the start or gradually worsen over time as the disease progresses.

Low red cell count (anemia) can cause:

  • Fatigue
  • Pallor (paleness)
  • Rapid heart rate
  • Shortness of breath with exercise
  • Weakness
  • Lightheadedness upon standing

Low white cell count (leukopenia) causes an increased risk for infection.

Low platelet count (thrombocytopenia) can result in bleeding. Symptoms include:

  • Bleeding gums
  • Easy bruising
  • Nose bleeds
  • Rash, small pinpoint red marks on the skin (petechiae)
  • Frequent or severe infections (less common)
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What are the current treatments for Aplastic Anemia?

Mild cases of aplastic anemia that do not have symptoms may not require treatment.

As blood cell counts become lower and symptoms develop, blood and platelets are given through transfusions. Over time, transfusions may stop working, resulting in very low blood cell counts. This is a life-threatening condition.

Bone marrow, or stem cell transplant may be recommended for younger people. It is more likely to be recommended for those 50 years and younger, but people over 50 may receive a transplant if they are healthy enough. This treatment works best when the donor is a fully-matched brother or sister. This is called a matched sibling donor..

Older people and those who do not have a matched sibling donor are given medicine to suppress the immune system. These medicines may allow the bone marrow to once again make healthy blood cells. But the disease may return (relapse). A bone marrow transplant with an unrelated donor may be tried if these medicines do not help or if the disease comes back after getting better.

Who are the top Aplastic Anemia Local Doctors?
Highly rated in
Hematology Oncology

University of Texas System

Physicians Referral Service

1515 Holcombe Blvd 
Houston, TX 77030

Tapan Kadia is an Oncologist and a Hematologist Oncology doctor in Houston, Texas. Dr. Kadia has been practicing medicine for over 21 years and is rated as an Elite doctor by MediFind in the treatment of Aplastic Anemia. He is also highly rated in 30 other conditions, according to our data. His top areas of expertise are Acute Myeloid Leukemia, Myelodysplastic Syndrome, Leukemia, and Acute Myeloblastic Leukemia without Maturation. He is board certified in Internal Medicine, Hematology, and Medical Oncology and licensed to treat patients in Texas. Dr. Kadia is currently accepting new patients.

Highly rated in
Hematology Oncology

Cleveland Clinic Health System

Cleveland Clinic Main Campus

9500 Euclid Ave 
Cleveland, OH 44195

Jaroslaw Maciejewski is a Hematologist Oncology doctor in Cleveland, Ohio. Dr. Maciejewski has been practicing medicine for over 32 years and is rated as an Elite doctor by MediFind in the treatment of Aplastic Anemia. He is also highly rated in 32 other conditions, according to our data. His top areas of expertise are Aplastic Anemia, Paroxysmal Nocturnal Hemoglobinuria, Paroxysmal Cold Hemoglobinuria, and Myelodysplastic Syndrome. He is board certified in Hematology/oncology and Internal Medicine and licensed to treat patients in Ohio. Dr. Maciejewski is currently accepting new patients.

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Highly rated in

Kanazawa University

Kanazawa, JP 

Shinji Nakao is in Kanazawa, Japan. Nakao is rated as an Elite expert by MediFind in the treatment of Aplastic Anemia. He is also highly rated in 21 other conditions, according to our data. His top areas of expertise are Aplastic Anemia, Anemia, Pure Red Cell Aplasia, and Paroxysmal Nocturnal Hemoglobinuria.

What is the outlook (prognosis) for Aplastic Anemia?

Untreated, severe aplastic anemia leads to rapid death. Bone marrow transplant can be very successful in young people. Transplant is also used in older people or when the disease comes back after medicines have stopped working.

What are the possible complications of Aplastic Anemia?

Complications may include:

  • Severe infections or bleeding
  • Complications of bone marrow transplant
  • Reactions to medicines
  • Hemochromatosis (buildup of too much iron in the body tissues from many red cell transfusions)
When should I contact a medical professional for Aplastic Anemia?

Call your health care provider or go to the emergency room if bleeding occurs for no reason, or if bleeding is hard to stop. Call if you notice frequent infections or unusual fatigue.

Bone marrow aspiration
What are the latest Aplastic Anemia Clinical Trials?
A Phase II Clinical Trial to Evaluate the Efficacy of the Infusion of Autologous CD34+ Cells Transduced With a Lentiviral Vector Carrying the FANCA Gene (Orphan Drug) in Patients With Fanconi Anemia Subtype A
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A Phase II Study of Olaparib in Patients With Advanced Biliary Tract Cancer With Aberrant DNA Repair Gene Mutations
What are the Latest Advances for Aplastic Anemia?
Fecal microbiota transplantation for refractory Clostridioides difficile infection with Crohn's disease in an allogeneic bone marrow transplant recipient.
Successful treatment of secondary graft failure after allogeneic stem cell transplantation for aplastic anemia with eltrombopag.
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The efficacy of eltrombopag plus cyclosporine A in patients with transfusion-dependent non-severe aplastic anemia: a retrospective study from single center.
Who are the sources who wrote this article ?

Published Date : February 06, 2020
Published By : Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Bagby GC. Aplastic anemia and related bone marrow failure states. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 156.

Culligan D, Watson HG. Blood and bone marrow. In: Cross SS, ed. Underwood's Pathology. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 23.

Young NS, Maciejewski JP. Aplastic anemia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 30.