Aplastic Anemia: What It Is, Causes, and Signs

The diagnosis of "aplastic anemia" sounds frightening, and the internet immediately offers a dozen horror stories. In short: the problem is not that there is too little iron in the blood or that you don't eat enough buckwheat, but that the bone marrow stops producing new blood cells. Below is a calm, point-by-point explanation of what happens and which signs fit this picture.

What aplastic anemia is

The bone marrow is the soft, spongy tissue inside bones where red blood cells, white blood cells, and platelets are born. In aplastic anemia, the stem cells of this "factory" are damaged, and fewer blood cells are produced than the body needs. Despite the name, this is not simply anemia but bone marrow failure, and it affects all three cell lines at once. The disease can develop quickly or slowly and be mild or severe. There is currently no way to prevent it.

Aplastic and hypoplastic anemia: what the difference is

Hypoplastic anemia is another name for aplastic anemia; other terms also occur: aregenerative anemia, myeloparesis, panmyelophthisis. They refer to the same condition, in which blood formation is suppressed and there are few cells in the blood. The classic picture is pancytopenia, that is, a decrease in all three cell lines. There is also a partial hypoplastic form, in which only red blood cell production is affected.

Causes of aplastic anemia

The underlying problem is damage to the bone marrow stem cells. The most common cause is the body's own immune system: it attacks and destroys the stem cells, and this is a variant of autoimmune disease. Next on the list: certain medications, including those used in chemotherapy; toxic substances in the environment, such as benzene; irradiation and radiation; viruses and other infections; autoimmune diseases such as systemic lupus erythematosus; pregnancy. In some cases, no cause can be found — then it is called idiopathic aplastic anemia.

Congenital aplastic anemia

In rare cases, the disease is inherited. It is the same condition: the bone marrow cannot produce enough new blood cells.

Signs of aplastic anemia

Symptoms depend on which cells are lacking. The picture may be severe from the very beginning or worsen gradually.

• Too few red blood cells: fatigue, pallor, weakness, rapid pulse, shortness of breath on exertion, dizziness when standing up.
• Too few white blood cells: increased risk of infections, infections that do not resolve for a long time, frequent or severe infections.
• Too few platelets: bleeding gums, easy bruising, nosebleeds, small pinpoint red rash.
• General background: ringing in the ears, reduced ability to work, poor tolerance of prolonged exertion, palpitations at rest.

How it is diagnosed and when to see a doctor urgently

The conversation begins with blood tests: in this disease, they show low red blood cells, white blood cells, and platelets, and the reticulocyte count — the youngest red blood cells — is also reduced. A bone marrow biopsy is usually offered next: the sample contains fewer cells than normal and more fat. Based on the results, the doctor explains whether the form is mild or severe and what happens next. Without treatment, severe forms are dangerous because of bleeding, severe infections, heart rhythm disturbances, and heart failure. See a doctor for persistent unexplained fatigue and frequent infections, and without delay for bleeding without a cause.

Aplastic anemia by itself is not a reason to call an ambulance. Call 103 or 112 if bleeding starts without a cause or the blood is difficult to stop.

And remember: this is reference text, not a consultation — a doctor reviews your test results and condition with you.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer