Aplastic Anemia and MDS: Causes, Symptoms, Treatment

What Causes Aplastic Anemia and MDS?

Aplastic anemia and MDS (myelodysplastic syndrome) are diseases in which the body experiences abnormalities of blood cell levels.  The bone marrow discontinues making enough red and white blood cells and platelets, and the results can be moderate, severe or extremely severe.  People who suffer from aplastic anemia are at high risk for life threatening infections and bleeding.  Though aplastic anemia is rare, it appears mostly in eastern Asian countries and affects one in every fifteen people of varying ages.

MDS actually encompasses several different syndromes and other syndromes include; myelofibrosis, prominent eosinophilia or monocytosis.  Those who suffer from an MDS-related syndrome are at a higher risk of developing blood cancer and certain forms of anemia. Other disorders which can develop include refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excessive blasts in transformation, chrome myelomonocytic leukemia and refractory anemia with excessive blasts.  

While there are different causes of aplastic anemia and MDS that are of unknown etiology, there are also experts who believe the disease is caused by a variety of different factors such as: 

• Radiation exposure
• DNA damaging medications
• Benzene exposure
• An inherited disorder
• Viruses
• Chemicals
• Autoimmune disorders
• Pregnancy

There are many unknown variables to consider when determining the cause of aplastic anemia and MDS, more research is required before scientists can uncover definitive causes for the disease.

Signs, Symptoms and Diagnosis of Aplastic Anemia and MDS 

There are a variety of different signs and symptoms which will be present when someone is experiencing aplastic anemia or MDS.  Most of the symptoms of the disease are caused by low numbers of blood cells in the body and this will determine the severity of what a person experiences:

• Fatigue because of a low number of red blood cells
• Frequent and serious infections which can be due to a low number of white blood cells in the body.
• Shortness of breath after exertion
• Bleeding from the nose and gums
• Rapid or irregular heart rate
• Prolonged bleeding from wounds or cuts
• Rash on the skin
• Dizziness
• Headache
• Easily or unexplainable bruising
• Pale color to the skin

The disease can progress slowly over a matter of months or weeks, or can be fast-moving and appear suddenly.  The severity of illness a person experiences can be brief or become chronic, and without proper medical attention and treatment the disease can be fatal.

Diagnosing Aplastic Anemia and MDS

A medical professional will use a number of diagnostic tests in order to make a positive diagnosis of aplastic anemia and MDS.  The tests can include the following:

Blood tests:  to check the range of red and white blood cells and platelets in the body.  A physician might suspect aplastic anemia when all three levels of blood cells are low.

Bone marrow biopsy:  to make a definitive diagnosis, a physician will have a person undergo a needle biopsy to remove a small sample of bone marrow to be used for testing. 

When a person receives a positive diagnosis of aplastic anemia or MDS, further testing may be ordered, to determine the cause and severity of the disease.  Any additional testing would also be conducted to determine any underlying conditions that might be present as well.

Treatment for Aplastic Anemia and MDS

Treatment methods used for aplastic anemia would be determined by whether the person is suffering from a mild, moderate or severe form of the disease.  Severe aplastic anemia and MDS can be life threatening and requires immediate medical attention and hospitalization.  Mild to moderate aplastic anemia and MDS, while still serious, does not usually require a person to be in the hospital for treatment.

Most people who suffer from aplastic anemia and MDS need to have multiple blood transfusions of blood cells or platelets, and sometimes both.  A blood transfusion is not a cure of the disease, but can alleviate the signs and symptoms and make the person feel better.  While there is no limit to the amount of transfusions a person can have, there can sometimes be complications associated with multiple transfusions which can be risky for the person.

Another treatment option is bone marrow transplantation, which will involve replacing the diseased bone marrow from a donor source.  A bone marrow transplant can sometimes be the only way to successfully treat severe forms of aplastic anemia and MDS.  Bone marrow transplants can also be a good option for those who are young and can find a potential match in a sibling or parent.  As with any surgical procedure, a bone marrow transplant carries some potential risks which could include fatal complications such as rejection or infection.

Immunosuppressant drugs can be used to treat aplastic anemia which is due to an autoimmune disorder.  To prevent the disease from progressing, a physician can use immune suppressing drugs to alter the function of the immune system.  The drugs will stop the action of the immune system and keep the immune cells from damaging the bone marrow, which in turn helps the body generate new red blood cells.

Other options to treat aplastic anemia can include bone marrow stimulants which will stimulate bone marrow to produce new blood cells.  Bone marrow stimulants can be used in combination with immune-suppressing drugs when not effective alone.  Antibiotics and antivirals can also help a person resist infections which can weaken the immune system and lower white blood cell counts in the body.

When aplastic anemia is caused by radiation exposure or chemotherapy drugs, the condition will usually improve once the treatment concludes.  In cases of pregnancy related aplastic anemia, the condition will usually end when the woman gives birth to the baby.  If all treatment methods fail, the disease can be fatal.

Overview

While aplastic anemia and MDS can be fatal, with the right treatment methods and medications the signs and symptoms can be controlled.  A person should eat a healthy diet, get adequate rest and follow standard infection precautions, avoid excessive exercising and contact sports, and strictly adhere to the recommendations and advice of their medical professional to achieve the best prognosis possible.