Aplastic Anaemia is a life-threatening blood condition with high death rates if untreated. It is an autoimmune condition where the body’s immune system turns around and destroys the bone marrow. As a result, patients can present with very low blood counts with symptoms related to this, including fatigue, heart failure, infections and bleeding or bruising.

The overall five-year survival rate is about 70-80%. However, in recent years, the long-term outcomes of Aplastic Anaemia patients have been continuously improving. 

While Aplastic Anaemia may not always present with symptoms. However, some early signs are indicative of the condition due to the falling blood counts from the suppression of the bone marrow. These include fatigue, shortness of breath, unexplained bruising, and prolonged bleeding from cuts.

Aplastic Anaemia is an autoimmune condition in which the body’s immune system attacks and damages the stem cells in its bone marrow. As a result, these damaged stem cells cannot produce blood cells properly and cause the bone marrow to be either empty (Aplastic) or contain inadequate blood cells (hypoplastic). 

In the majority of cases (75-80% of the time), the cause of aplastic anaemia is unknown (called Idiopathic Aplastic Anaemia). There are causes that can trigger Aplastic Anaemia, including chemotherapy and radiation, autoimmune disorders, pregnancy, and some viral infections.

There is a rare group of disorders known as bone marrow failure syndromes where Aplastic Anaemia can be sometimes passed down from one generation to the next. 

Anaemia is a blood condition due to low red blood cells. This can be due to causes such as blood loss from surgery or bleeding or could be due to dietary deficiency (most commonly as a result of iron deficiency). Anaemia could also result from bone marrow disorders that suppress the production of red cells, such as Blood Cancers or Aplastic Anaemia. 

Aplastic Anaemia is an autoimmune condition resulting in the suppression of cells in the bone marrow which produce healthy blood cells. This usually causes Anaemia and lowers the other blood counts (white cells and platelets). 

Aplastic Anaemia is a serious illness. However, depending on the severity of the condition, different forms of treatment are available. Treatments for Aplastic Anaemia are based around the use of immunosuppressive agents to suppress the destruction of the bone marrow by the body’s immune system.  

In severe cases of Aplastic Anaemia or in patients who have relapsed Aplastic Anaemia, allogeneic haematopoietic stem cell transplantation may be required.

However, even with the success rates of present treatments, there remains a risk of relapse of Aplastic Anaemia. 

Aplastic Anaemia is a serious blood condition. If untreated, patients will suffer from the ongoing side effects of an ineffective bone marrow. Patients may require ongoing blood and platelet transfusions or experience recurrent infections and/or bleeding or easy bruising.  

In severe cases of Aplastic Anaemia, the lack of early treatment is associated with a high risk of serious complications, including death.

The majority of cases of Aplastic Anaemia are not hereditary (i.e. they are not passed down from one generation to the next).  

However, there is a small proportion of cases where Aplastic Anaemia may be passed down through the genes from parent to child. It is usually diagnosed during childhood and is much less common than acquired Aplastic Anaemia.

This is usually part of a rare group of conditions known as Bone Marrow Failure Syndromes. People who develop hereditary Aplastic Anaemia usually have other genetic or developmental abnormalities associated with the Aplastic Anaemia.

As Aplastic Anaemia requires treatments with drugs that suppress the immune system, it is usually recommended that couples do not try to get pregnant while on treatment for Aplastic Anaemia. 

Pregnancy can sometimes trigger Aplastic Anaemia or worsen the condition. Hence, you should consult with our haematologist if considering pregnancy with a background of Aplastic Anaemia. 

The treatment for Aplastic Anaemia depends on the age and severity of the patient’s condition. The aim of treatment is to restore blood cell production. If the condition is mild, it may resolve spontaneously without the need for treatment, although this is not very common.  

Patients likely need supportive care in the form of blood and platelet transfusions and antibiotics, and antivirals to prevent and control infections. 

Treatment of Aplastic Anaemia involves the use of immunosuppressive drugs such as ATG (anti-thymocyte globulin) or cyclosporine A. Platelet-supporting drugs such as eltrombopag are increasingly used to support the blood count to reduce the need for transfusion.

In patients with more severe forms of Aplastic Anaemia, an allogeneic haematopoietic stem cell transplantation may be considered if a suitable donor is identified.

Blood transfusions can relieve the symptoms of Aplastic Anaemia by supplementing the body with blood cells that the bone marrow cannot produce.

Patients may develop iron overload which may result in damage to the heart, liver, and other vital organs. Iron chelation therapy that involves the removal of excess iron from the body can help to minimise the risk of such iron toxicity.

Not all patients with Aplastic Anaemia require a bone marrow transplantation (Allogeneic haematopoietic stem cell transplantation). Patients with more severe forms of aplastic anaemia who have not responded to conventional immunosuppressive therapy or those who have a readily available matched sibling or unrelated donor are often considered for transplantation.

There are a number of complications that can occur after a stem cell transplant. These include both short term and long term complications.

Patients may experience short term complications such as mouth and throat pain, vomiting or nausea, infection, or graft-versus-host-disease (GVHD). Longer-term complications include disease relapse, GVHD, cardiac and hormonal changes, as well as secondary cancers.

Our transplant team will work closely with you through the different phases of your transplant to monitor, prevent and manage any such complications.

The first stage of recovery after a bone marrow transplant typically takes 4 to 6 weeks. This is the period in which our transplant team will monitor you to see if engraftment has occurred.

Typically, patients remain in the hospital until their blood counts stabilise and the patient is fit and independent without any infective complications.

Full recovery after a bone marrow transplant can take between 6 months to a year.

A bone marrow transplant can fail if the body does not accept the new donor cells. This is known as graft failure and is suspected in patients whose counts do not increase after three to four weeks following a bone marrow transplant.

Graft failure can result in severe bleeding and infection and is more likely to occur in patients who receive a lower number of stem cells or when the patient and donor are not well matched.

Should a patient’s graft fail, they can receive a second dose of stem cells from the original donor. Sometimes a second transplant from a different donor is required.