Aplastic Anemia

Causes and Etiology

Aplastic anemia can be either congenital or acquired. Congenital forms are caused by genetic abnormalities, such as Fanconi anemia. Acquired forms are much more common.

Risk factors:

• Exposure to toxins (benzene, solvents)

• Medications (cytostatics, antibiotics, anticonvulsants)

• Viral infections (hepatitis, HIV, Epstein-Barr)

• Autoimmune processes

• Radiation exposure

Classification of Aplastic Anemia

Aplastic anemia is classified by severity based on blood cell counts and bone marrow activity.

Moderate Aplastic Anemia

A form in which blood cell production is reduced but severe manifestations may be absent. Often requires observation and conservative therapy.

Severe Aplastic Anemia

Characterized by significant suppression of hematopoiesis and decreased levels of neutrophils, platelets, and reticulocytes. Patients require active treatment.

Very Severe Aplastic Anemia

Marked by critically low levels of all blood cell types. Requires urgent treatment, including bone marrow transplantation.

Symptoms and Signs

Anemic Syndrome:

• Weakness, fatigue

• Dizziness

• Shortness of breath during physical activity

Hemorrhagic Syndrome:

• Bleeding gums

• Frequent nosebleeds

• Petechiae (small pinpoint skin hemorrhages)

Infectious Complications:

• Frequent and severe infections

• Fever

• Inflammations without apparent cause 

Diagnosis

Laboratory Methods:

• Complete blood count (pancytopenia)

• Reticulocyte count — decreased

• Biochemical markers

• Bone marrow analysis (aspirate): hypocellularity

Instrumental Methods:

• Ultrasound of spleen and liver

• MRI/CT (if needed to rule out other conditions) 

Treatment of Aplastic Anemia

The choice of treatment depends on disease severity, patient age, and donor availability.

Blood Transfusions

Used for temporary improvement in severe anemia or thrombocytopenia. Red blood cell and platelet concentrates are administered.

Bone Marrow Transplantation

The most effective method for severe cases in younger patients with a suitable donor. Bone marrow transplantation can lead to full recovery.

Immunosuppressive Therapy

Used when no donor is available. Drugs that suppress the immune system attacking the bone marrow are prescribed.

Bone Marrow Stimulation

Medications that stimulate hematopoiesis are administered. These may include growth factors (e.g., G-CSF) and other stimulants.

Symptomatic Treatment

Includes antibacterial and antifungal therapy for infections, hemostatic agents, and general supportive care for the patient.

Complications

Aplastic anemia may lead to:

• Severe infections

• Heavy bleeding

• Acute leukemia (rarely)

• Death in the absence of treatment

Prognosis and Prevention

The prognosis depends on disease severity and timely treatment. Moderate forms are managed with long-term therapy, while severe cases require transplantation. Prevention includes avoiding toxic exposure, timely treatment of viral infections, and regular check-ups for at-risk individuals.

Treatment of Aplastic Anemia in Russia

Clinics

• MEDSI — hematology department, experienced physicians, individualized treatment protocols, transplant preparation.
• EMC (European Medical Center) — treatment according to international protocols, bone marrow transplantation, modern diagnostics.
• Scandinavia — comprehensive diagnostics and treatment, evidence-based methods, monitoring under the supervision of a hematologist.

Cost

Treatment cost depends on the severity, need for transplantation, duration of therapy, and medications used. The average cost ranges from $3,100 to $15,300. The exact amount is determined after diagnosis and treatment planning.

MARUS Assistance

MARUS helps patients with rare and severe conditions gain access to advanced diagnostic and treatment methods in leading medical institutions in Russia. Patient support includes clinic selection, appointment coordination, logistics, and assistance throughout all stages of therapy. This is especially important for such a complex disease as aplastic anemia.

Treatment for aplastic anemia in Russia is accessible if professional help is sought in time and the treatment and follow-up process is properly organized.