The etiology of aplastic anemia

Written by Li Fang Fang

Hematology

Updated on September 17, 2024

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The etiology of aplastic anemia currently has no absolute cause, but the more supported theories concerning its etiology include the soil, pest, and seed theories.

The soil theory refers to abnormalities in the microenvironment within the bone marrow, which causes an abnormal growth environment for hematopoietic stem cells, consequently limiting their growth.

The seed theory indicates a decrease in the number and quality of hematopoietic stem cells in the bone marrow, leading to bone marrow regeneration failure.

The pest theory refers to immunological factors, which play a significant role in aplastic anemia, suggesting a disorder in the patient's immune function that leads to bone marrow regeneration failure.

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Written by Li Fang Fang

Hematology

1min

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What to eat for aplastic anemia

Patients with aplastic anemia should eat light, easily digestible foods, and soft diet, avoiding too hard foods, and foods with spines or bones to prevent these foods from scratching the mucous membrane of the digestive tract and causing gastrointestinal bleeding. Additionally, patients with aplastic anemia must also take medications to control the progression of the disease, the related medications mainly include immunosuppressants, such as cyclosporine, as well as hematopoietic stimulants and traditional Chinese medicine formulations. Hematopoietic drugs include androgens, such as danazol and stanozolol, etc., and traditional Chinese medicines include compound alumite pills, rejuvenating blood tablets, etc. (Please use specific medications under the guidance of a doctor, and do not self-medicate.)

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Written by Zhang Xiao Le

Hematology

59sec

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The differences between aplastic anemia and megaloblastic anemia.

Aplastic anemia is a type of bone marrow failure syndrome where patients can present with reduced total blood cells in the peripheral blood, without enlargement of the liver, spleen, or lymph nodes, and an increased ratio of peripheral blood lymphocytes. Bone marrow indicates low regeneration, reduced hematopoietic tissue, and increased non-hematopoietic tissue, with the condition arising from changes in the bone marrow microenvironment leading to a reduction in blood cells. Megaloblastic anemia, also known as nutritional anemia, is primarily caused by a lack of folate and vitamin B12, leading to a red blood cell synthesis disorder and resulting in anemia. Severe megaloblastic anemia can also present with reduced total blood cells. However, the red blood cells typically exhibit macrocytic anemia. In contrast, aplastic anemia generally presents with normocytic anemia.

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Written by Li Fang Fang

Hematology

59sec

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Which is more severe, aplastic anemia or leukemia?

Aplastic anemia is not leukemia. Leukemia is characterized by more than 20% primary cells in the bone marrow being classified as leukemia. Aplastic anemia, on the other hand, is a bone marrow failure disease, characterized by a reduction in hematopoietic cells in the bone marrow, leading to a decrease in all blood cells. Aplastic anemia can be divided into acute aplastic anemia and chronic aplastic anemia. Acute aplastic anemia has a rapid onset, severe condition, and high mortality rate, while chronic aplastic anemia has a slow onset, longer disease history, and lower mortality rate. Treatment for acute aplastic anemia requires intensified immunotherapy or syngeneic complete match transplantation, whereas treatment for chronic aplastic anemia mainly involves promotive hematopoietic therapy.

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Written by Zhang Xiao Le

Hematology

42sec

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Is it good to transfuse platelets for aplastic anemia with low platelets?

Aplastic anemia is a type of bone marrow failure syndrome, with patients often experiencing a decrease in all blood cells in the peripheral blood. As a result, patients typically face a higher risk of infections and bleeding. Treatment for aplastic anemia is a long-term process, and hematopoiesis often cannot be restored quickly. Therefore, especially in severe cases of aplastic anemia, patients' blood cells remain at relatively low levels for an extended period, placing them at severe risk of infections and bleeding. If platelets fall below 20*10^9/L, it is necessary to administer platelet transfusions to prevent severe bleeding.

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Written by Zhang Xiao Le

Hematology

49sec

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What tests should be done to diagnose aplastic anemia?

The diagnostic criteria for aplastic anemia include a decrease in all blood cells, generally no enlargement of the liver or spleen, reduced or severe reduction in bone marrow hyperplasia in multiple sites, and exclusion of other diseases causing a decrease in all blood cells. Therefore, the diagnosis of aplastic anemia requires the following tests: complete blood count, reticulocyte count, abdominal ultrasound, bone marrow cytology, bone marrow chromosome analysis, bone marrow biopsy, rheumatoid immune indicators, and peripheral blood T-cell subgroups. Additionally, for patients suspected of having aplastic anemia, further flow cytometry and differentiation from myelodysplastic syndromes are sometimes necessary.