While most people are familiar with common anaemia caused by iron deficiency, a much rarer and more perilous form of the disease exists: aplastic anemia. Also described as ‘bone marrow failure’, this condition represents a critical breakdown in the body’s internal blood-production factory. Also read | Demystifying anemia: 7 lesser-known causes to be aware of
In an interview with HT Lifestyle, Dr Sandip Shah of the Hemato-Oncology Clinic at the Vedanta Institute of Medical Sciences, provided a detailed roadmap for understanding, diagnosing, and treating aplastic anemia.
Understanding the ‘bone marrow failure’
Characterised by Dr Shah as a ‘rare but serious blood disorder’, the condition remains a critical challenge in modern internal medicine. At its core, aplastic anemia is a functional shutdown of the body’s blood production. According to Dr Shah, it is a condition ‘in which the bone marrow fails to produce enough red blood cells, white blood cells, and platelets.
He added that this leads to a state of ‘bone marrow failure,’ warning: “Without adequate blood cell production, patients become severely anemic and remain at high risk of life-threatening infections and bleeding.“
Who gets it and why?
While the disease does not discriminate by age, Dr Shah observed that it is ‘more commonly seen in younger adults’. Pinpointing a single origin is often difficult, as ‘in many cases the exact cause remains unknown’.
However, the oncologist identified several specific environmental and biological triggers:
⦿ Genetic causes
⦿ Certain drugs
⦿ Exposure to chemicals such as benzene
⦿ Radiation
⦿ Viral infections
⦿ Autoimmune attacks on the body’s stem cells
Identifying the warning signs
Dr Shah urged the public to be vigilant regarding physical changes, noting that ‘patients may experience persistent fatigue and shortness of breath due to low red blood cell levels’.
Other critical symptoms include:
⦿ Bleeding from different sites in the body
⦿ Frequent mouth ulcers and easy bruising
⦿ Recurrent fever or infections because of reduced white blood cells
To move beyond symptomatic suspicion, a clinical ‘bone marrow biopsy’ is required. Dr Shah explained that this definitive test: “Usually shows low counts in all three blood cell lines along with bone marrow that is largely replaced by fat.“
The path to recovery: treatment and hope
The medical landscape for aplastic anemia has shifted toward high recovery rates. For ‘young and fit individuals’, Dr Shah stated that the ‘definitive treatment is early referral for a hematopoietic stem cell transplant’. This can come from a ‘fully matched sibling donor’ or donors found through ‘national or international registries’.
He said, “With improvements in transplant techniques and growing medical expertise, the cure rate in young patients can now reach as high as 90 percent.” For ‘elderly or unfit patients’, Dr Shah recommended a ‘triple immunosuppressive therapy consisting of antithymocyte globulin, cyclosporine, and eltrombopag’. This regimen can ‘help the bone marrow recover and improve survival in nearly 60 percent of patients’.
The challenge in India
Despite the high cure rates in clinical settings, Dr Shah highlighted systemic barriers in India, noting, “Many patients face delays in treatment because of limited access to specialised care and socioeconomic constraints.” Furthermore, he pointed to a ‘lack of awareness and willingness among the public to register as stem cell donors’.
Dr Shah concluded with a multi-pronged call for action: “There is a need for stronger public support for stem cell registries so that more patients can find suitable donors. Specialist treatment centres should be strengthened and expanded in smaller cities to improve access to care. Ensuring affordable access to drugs through government schemes can also help many patients receive timely treatment.”
Ultimately, Dr Shah highlighted that recognising warning signs ‘should lead to early medical consultation and prompt referral for haematological evaluation’.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
