Aplastic anemia

NOOR ABU-AMARA
GROUP 1 – STOMATOLOGY
SEMESTER 7
Definition
 Aplastic anemia is pancytopenia with bone marrow
Hypocellularity.
 Pancytopenia A condition in which there is a
lower-than-normal number of red and white blood
cells and platelets in the blood
 Hypocellularity the state of having abnormally
few cells
 Anemia (↓RBC) + Leukocytopenia (↓WBC) +
Thrombocytopenia (↓ platelet)
Bone marrow morphology
 There are two types of bone marrow:
1. Red bone marrow contains blood stem cells that can become red
blood cells, white blood cells, or platelets.
2. Yellow bone marrow is made mostly of fat
 So when we have aplastic anemia the red bone marrow ↓ as there is
a destruction of the blood stem cells and so the bone marrow will
appear yellow
Types of aplastic anemia
1. Idiopathic
2. Acquired
3. Inherited

 It can also be classified according to severity

1. Moderate
2. Severe
3. Very severe
Etiology
1. Idiopathic
2. Radiation (damages DNA)
3. Inherited disease (Fanconi’s anemia, an autosomal recessive disorder)
4. Chemicals (Benzene is a notorious cause of bone marrow failure)
5. Drugs (some chemotherapy drugs have marrow suppression as a major toxicity)
6. Infections (EBV and Hepatitis)
7. Immunologic diseases (Aplasia is a major consequence in transfusion-associated graft-versus-host disease)
8. Pregnancy (Aplastic anemia very rarely may occur)
Symptoms
 Low RBC (Anemia) symptoms
1. Fatigue
2. Chest pain – shortness of breath
3. Pallor
 Low WBC (Leukopenia) symptoms
1. Fever
2. Infections
3. Ulceration of buccal mucosa
 Low platelets (thrombocytopenia) symptoms
1. Mucosal bleeding
2. Petechiae
3. Easy bruising
 Normal peripheral blood
1. HGB
 Fi index
 Women 120 - 150 gM/dL
 HBG/ RBC = 0.8 – 1.05
 Men 130 – 160 gM/Dl
 ↓ HGB ≤ 0.8 (hypochromic, microcytic)
2. RBC
 ↓ RBC ≤ 1,05 (hyperchromic, macrocytic)
 Women 3.5 – 4.5 (million)
 Aplastic anemia is normocytic-normochromic
 Men 4.5 – 5.5 (million)
anemia
3. Platelets 150 – 400 (thousand)
 (RBCs) are the same size (normocytic) and have a
4. Reticulocyte 2 – 15 gM/dL normal red color (normochromic)
5. Eosinophil 2 – 6 %
6. Basophil 0 – 1 %
7. Lymphocytes 20 – 40 %
8. Segements 40 – 60%
9. Band cells 1 – 6%
 Bone marrow aspiration

Diagnosis
1. CBC 2. Bone marrow test
 HGB- ↓  Bone marrow aspiration (fluid)
 RBC- ↓  Bone marrow biopsy (tissue)
 Fi- Normal or ↓
Hypocellular and ↑ fat spaces
 MCV- Normal or ↓
 WBC- ↓ Bone marrow biopsy

 PLT- ↓
 ESR- ↑
References

1. http://
217.147.228.48/catalog/bookdownload.php?tocken=43c3a347a48d9983955e824
6520eb8e2
2. https://www.slideshare.net/ChalinDrosera/aplastic-anemia-26599767
3. https://www.mayoclinic.org/diseases-conditions/aplastic-anemia/symptoms-caus
es/syc-20355015#:~:
text=Aplastic%20anemia%20is%20a%20condition,can%20develop%20at%20an
y%20age
4. https://www.nhlbi.nih.gov/health/anemia/aplastic-anemia
5. https://
www.hopkinsmedicine.org/kimmel_cancer_center/cancers_we_treat/blood_bone
_marrow_cancers/aplastic_anemia.html
Thank you
for
listening