Aplastic Anemia Treatment in India

Aplastic-anemia

What are the treatment options for Aplastic Anemia?

Aplastic Anemia is considered an auto-immune disease and is described as a rare blood disorder in which the bone marrow while producing normal and properly functioning cells, does not produce sufficient blood cells to support the needs of the body.  Aplastic Anemia can manifest in moderate to extremely severe forms and can appear at any age irrespective of gender.  People suffering from Aplastic Anemia can develop a variety of symptoms including an increased risk of uncontrolled bleeding and infections.  Currently, the only cure for Aplastic Anemia is a bone marrow transplant; however, in most cases, it can be managed with proper and regular medical attention.  

Cost of Treatment India
Bone Marrow Transplant Starting from $22,000
ATG + Cyclosporine Therapy Starting from $9,500

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Blood Cell Formation And Types

Your blood is made of various types of cells suspended in a fluid called plasma which is made up primarily of water and contains proteins, nutrients, hormones and other chemicals that are vital to your bodies proper function and health.

Blood cells come in three distinct forms each with its own unique function:

  • Red Cells (RBCs) – Also known as erythrocytes, the red blood cells are filled with hemoglobin, a type of protein that transports oxygen from the lungs throughout the rest of the body. RBCs make up approximately half of the blood cells in the body.
  • White Cells (WBCs) – White blood cells, or leukocytes, serve as an important part of the immune system by fighting the germs that cause infection and other illnesses. WBCs come in a variety of forms each specialized to defend the body against specific types of germs.
  • Platelets – Platelets, or thrombocytes, aid in blood clotting to allow the wounds to stop bleeding. Without platelets, and the ability to clot, even a minor cut would bleed indefinitely.

All blood cells are created inside spongy bone marrow that is inside certain bones. The stem cells in the bone marrow can develop into any of the three types of blood cell. Once the cell is mature it leaves the bone marrow and enters the bloodstream. In healthy individuals, the stem cells inside the bone marrow produce sufficient healthy cells. On rare occasions, however, there can be a failure in the bone marrow which leads to certain blood disorders such as Aplastic Anemia.

Symptoms of Aplastic Anemia

While all Aplastic Anemia is caused by insufficient red blood cells the symptoms vary greatly depending on the severity of the disease and how low the RBC count is. Symptoms can be further complicated by age and preexisting health conditions. 

Some of the most common symptoms of Aplastic Anemia include:

  • Rapid and/or irregular heartbeat or heart rate
  • Paleness or rashes
  • Fatigue and/or breathlessness with very little exertion
  • Headaches
  • Dizziness
  • Cuts that take a long time to stop bleeding or don’t stop
  • Bruising easily
  • Frequent infections and fevers

If these symptoms develop without a known cause it is recommended to see your physician for a checkup.

Causes of Aplastic Anemia

In rare instances Aplastic Anemia may be inherited however, it is generally considered an acquired illness. It is an autoimmune related disease in that the condition can trigger autoimmune responses in which the body’s immune system stops recognizing its own tissues and organs as part of the body and begins to attack it as if it the tissues and organs were a germ or virus.

Aplastic means empty and refers to the fact that the bone marrow is “empty” of mature red cells that can be released into the bloodstream. As the bone marrow slows in its production of new cells or stops producing them completely then Aplastic Anemia develops. This type of bone marrow failure can be caused by damage to the bone marrow.

Damage to the bone marrow can be caused by:

  • Exposure to Chemicals – Exposure to toxins that are found in substances like insecticides or pesticides can trigger Aplastic Anemia. When there is a chemical cause, the disease can be cured in its early stages by eliminating exposure to the toxic substance.
  • Autoimmune Disease – Some autoimmune diseases can cause the body to attack its own stem cells in the bone marrow and lead to Aplastic Anemia.
  • Radiation and Chemotherapy – While radiation and chemotherapy are useful treatments in the fight against cancer they sometimes have the side effect of damaging healthy stem cells such as those found in bone marrow. Aplastic Anemia caused by radiation and chemotherapy is typically a temporary, not a chronic, condition.
  • Viruses – A link has been discovered between some viruses such as HIV, Parvovirus and Hepatitis and Aplastic Anemia.
  • Pregnancy – In very rare instances pregnant women may develop Aplastic Anemia due to an acute autoimmune condition triggered by the pregnancy.
  • Drugs – Some drugs, such as antibiotics and those used to treat rheumatoid arthritis have been linked to instances of Aplastic Anemia.

Diagnosis of Aplastic Anemia

Aplastic Anemia is diagnosed by microscopic examination of the cells of the bone marrow, collected from the hip bone, and blood.  Once the samples are collected a lab will examine the number of all blood cells that are present as well as the ratio between the blood cells.  Kidney function may also be tested as poor kidney function and be indicative of Aplastic Anemia.  The final diagnosis is typically made by a senior bone marrow specialist and can be moderate, severe or very severe.

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Treatment of Aplastic Anemia

The available treatment options for Aplastic Anemia depends on the stage of the disease (moderate, severe or very severe), the age of the patient and the availability of a donor. In cases of moderate aplastic anemia, the treatment generally consists of drug therapies that control the condition and treat the symptoms. When Aplastic Anemia has reached the severe or very severe stage the treatment is typically dictated by age. In patients under the age of 40, who have a suitable donor available, a bone marrow transplant is the preferred treatment. If a patient is over 40 years old or does not have a suitable donor then drug therapies are recommended. Some of the most common treatment options include:

  • Transfusion – If the blood cell count is drastically low doctors may use a transfusion of blood platelets to raise the cell count. Transfusions can reduce symptoms such as fatigue, shortness of breath and hemorrhage. Although transfusion offers quick relief of symptoms it is rare for it to lead to a long-term recovery.
  • Drug Therapy – When a bone marrow transplant is not an option due to age, health risks or lack of donor, the immunosuppressive drugs anti-thymocyte globulin (ATG) and cyclosporine are used. While this combined drug therapy can induce a partial restoration of blood cell production it is not a cure. In rare cases, marrow from an unrelated donor may be used if drug therapies are not effective and the Aplastic Anemia is very severe.
  • Allogenic Bone Marrow Transplant – Sometimes referred to as a stem cell transplant a bone marrow transplant is one of the most successful treatments and the only possible cure for Aplastic Anemia. The damaged bone marrow is destroyed using radiation or chemotherapy. Bone marrow from a suitable donor, typically a close family member, is then used to replace the bone marrow of the patient.
  • Supportive Care – If a patient requires regular transfusions to keep the disease in check a central venous catheter may be implanted to make the transfusions and administration of any required drugs easier. Packed RBCs (red blood cells) are kept on hand to treat any blood deficiencies that may arise and to avoid cardiopulmonary complications. An additional aspect of supportive care is the administration of antivirals, antibiotics, and antifungals to treat the frequent infections associated with Aplastic Anemia.

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Dr. Surbhi Suden is one of the founders of Lyfboat and a doctor with a renowned name in the Medical tourism industry. She has been working with international patients since 2008 and is a deeply committed professional with a long term vision of transforming the current healthcare scenarios.

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