Aplastic anaemia causes your blood cell production to go down
It is a very sad time for my family. My husband was experiencing dizzy spells and tiredness. He went to a GP (general practitioner), who was concerned at his low red blood cell count and referred him to a specialist. At first, he was thought to be having leukaemia. But he was finally diagnosed as having aplastic anaemia. What is this disease?

Aplastic anaemia is a rare blood disease.

In the past, it used to be confused with leukaemia, but it is actually a separate disorder.

It occurs when your bone marrow cannot make enough blood cells and platelets.

It is rare, occurring in only one or two people out of a million, but it is very dangerous.

Where is my bone marrow?

Your bone marrow is the soft, gelatinous tissue that fills the central cavities inside your bones.

There are two types of bone marrow: red and yellow.

Red bone marrow contains myeloid tissue, which are made of blood-forming stem cells.

These cells produce your different blood cells and platelets.

Another term for them is haematopoietic (blood-producing) stem cells.

Yellow bone marrow contains mesenchymal stem cells, which produce your fat, cartilage and bone.

Both types of bone marrow are filled with fibrous tissue and blood vessels.

Stem cells are immature cells that can turn into many different types of cells.

Think of them as factory components that can be shaped into different things.

Yellow bone marrow is located in the most central part of your bone cavity, and is surrounded by a layer of your red bone marrow.

The whole thing looks like a sponge network.

How does my bone marrow function?

Your red bone marrow produces all your red blood cells and platelets, and around 60 to 70% of your white blood cells known as lymphocytes.

The bone marrow can also release immature lymphocytes to become fully matured in other organs, such as your spleen and lymph nodes.

Your red bone marrow also helps get rid of your old red blood cells, together with your liver and spleen.

Your yellow bone marrow acts as a store for fats.

The surprising thing about yellow bone marrow is that it can change into red bone marrow if your body really needs more blood cells, e.g. if you have severe blood loss in an accident, or if you have a fever and your body needs white blood cells to fight an infection.

The haematopoietic stem cells in your red bone marrow give rise to:

Red blood cells These cells transport oxygen throughout your body. They last about only four months, which is why your bone marrow has to constantly produce more to replace the ones that can no longer function.

White blood cells These cells fight infection. There are various different types of white blood cells, such as lymphocytes and granulocytes, which include like neutrophils, monocytes, eosinophils and basophils. They all form a team to fight different types of infection. Think of them as a strike force with different skill sets.

Platelets These help with to clot your blood if you get an injury and bleed.

As mentioned earlier, the mesenchymal stem cells in your yellow bone marrow can differentiate into cells that form your bone, cartilage, fat tissue and fibres.

What happens when you get aplastic anaemia?

In this condition, your bone marrow simply cannot make enough blood cells.

It can happen suddenly, or it can be more insidious.

It usually occurs in fairly young people aged 15 to 25.

It can also happen to people aged 60 and above.

But why would my bone marrow suddenly stop producing blood cells?

There are many conditions that can suddenly affect your bone marrow and cause it to fail.

It usually happens when your own immune system attacks your bone marrow so that it cannot make stem cells.

Scarily amazing, isn’t it?

The products of the factory (the white blood cells) can suddenly turn around and attack the factory!

Conditions that can cause an attack on your bone marrow include:

Autoimmune diseases such as systemic lupus erythemathosus (SLE)

Viral infections such as HIV (human immunodeficiency virus), Epstein-Barr virus and cytomegalovirus (CMV)

Pregnancy

Inherited conditions such as Fanconi anaemia.

It doesn’t mean that if you are pregnant or have any of these conditions that you will 100% get aplastic anaemia, but your risk will definitely be higher.

How will I know if I have aplastic anaemia?

The symptoms will be those produced by having a lack of red blood cells, white blood cells and platelets.

The symptoms develop slowly most of the time, but for some people, it can be very fast.

Lack of red blood cells can give rise to being fatigued all the time, as well as pallor, dizziness and headache.

Lack of white blood cells to fight infections can give rise to frequent viral infections that last longer than usual.

Lack of platelets can give rise to easy bruising as the blood doesn’t clot quickly under the skin.

These are also the symptoms of leukaemia, which is why doctors usually run tests to rule out this condition as well.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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In this blood disease, the bone marrow can’t make enough blood cells and platelets for the body to function normally.