Aplastic Anaemia: Symptoms, Causes, and Treatment
Learn about aplastic anaemia, including its symptoms, causes, and treatment options. Understand this rare blood disorder and how timely care can help.
Written by Dr. M L Ezhilarasan
Reviewed by Dr. Dhankecha Mayank Dineshbhai MBBS
Last updated on 8th Sep, 2025
Introduction
Imagine your body's bone marrow, the spongy factory inside your bones, suddenly shutting down. It stops producing the essential cells your body needs to survive: red blood cells to carry oxygen, white blood cells to fight infection, and platelets to stop bleeding. This is the reality of aplastic anaemia, a rare but serious condition. It's not a typical "anaemia" caused by nutritional deficiency; it's a bone marrow failure disorder. While a diagnosis can be frightening, understanding the signs is the first critical step toward effective treatment. This guide will walk you through the symptoms you shouldn't ignore, explore the potential causes, and detail the modern, life-saving treatment options that offer hope and a path to recovery. If you or a loved one are experiencing persistent, unexplained fatigue or bruising, this information is vital.
What is Aplastic Anaemia? A Breakdown of Your Bone Marrow
Discover what aplastic anaemia is and how it affects your bone marrow, impacting the production of vital blood cells and overall health.
The Role of Healthy Bone Marrow
Think of your bone marrow as a blood-forming factory. It contains haematopoietic stem cells, which are master cells that develop into all the different types of blood cells your body needs every single day. This constant production is essential for life, replacing old cells that die off.
What Goes Wrong in Aplastic Anaemia?
In aplastic anaemia, this factory is damaged and becomes almost empty, or aplastic. The stem cells are attacked, most commonly by the body's own immune system, and are unable to produce sufficient numbers of new blood cells. This leads to a condition called pancytopenia, which is a deficiency of all three blood cell types. It's this global shortage that causes the wide range of symptoms associated with the disease.
Consult a Haematologist for the best advice
Recognizing the Signs and Symptoms of Aplastic Anaemia
The symptoms of aplastic anaemia are directly linked to which blood cell type is most affected. They often appear gradually but can sometimes come on suddenly.
Symptoms from Low Red Blood Cells (Anaemia)
Red blood cells carry oxygen. Without enough of them (anaemia), your body's tissues are starved of oxygen, leading to:
• Persistent fatigue and weakness
• Shortness of breath with minimal exertion
• Dizziness or lightheadedness
• Pale skin
• Rapid or irregular heartbeat
• Chest pain
Symptoms from Low White Blood Cells (Neutropenia)
White blood cells are your army against infection. A low count (neutropenia) means you can't fight off germs effectively, resulting in:
• Frequent infections
• Fevers
• Sores in the mouth
• Recurrent flu-like symptoms
Symptoms from Low Platelets (Thrombocytopenia)
Platelets are crucial for clotting. A shortage leads to bleeding and bruising tendencies:
• Unexplained and easy bruising
• Prolonged bleeding from minor cuts
• Frequent or severe nosebleeds
• Bleeding gums
• Tiny, pin-sized red spots under the skin (petechiae)
• Heavy menstrual periods in women
When to See a Doctor Immediately
If you experience any combination of these symptoms of bone marrow failure, especially high fever, unexplained bruising, or severe shortness of breath, it is a medical emergency. Consult a doctor online with Apollo24|7 for an immediate evaluation or proceed to the nearest emergency room. Early diagnosis is critical.
What Causes Aplastic Anaemia? Triggers and Risk Factors
In about ¾ of cases, the cause is unknown ("idiopathic"). However, known causes are categorized as acquired or inherited.
Acquired Aplastic Anaemia (Most Common)
This form develops after birth and is often linked to an autoimmune response.
• Autoimmune Activity: In most cases, the body's immune system mistakenly attacks and destroys the stem cells in the bone marrow.
• Exposure to Toxins and Chemicals: Heavy exposure to pesticides, arsenic, and benzene (found in gasoline) is a known risk factor.
• Viral Infections and Certain Medications: Viruses like Epstein-Barr, hepatitis, or HIV can sometimes trigger it. Certain drugs, like some used in chemotherapy or to treat rheumatoid arthritis, are also associated.
Inherited Aplastic Anaemia (Rare)
These genetic disorders, such as Fanconi anaemia or Dyskeratosis congenita, make a person predisposed to developing bone marrow failure. These are usually diagnosed in childhood.
How is Aplastic Anaemia Diagnosed?
Diagnosis involves a series of steps to confirm bone marrow failure and rule out other conditions like leukemia or myelodysplastic syndromes.
The Complete Blood Count (CBC) Test
This is always the first step. A CBC will show low counts of all three blood cell lines (red, white, and platelets), raising the strong suspicion of aplastic anaemia or a related disorder. Apollo24|7 offers convenient home collection for CBC tests, making initial screening more accessible.
The Bone Marrow Biopsy: The Definitive Test
This is the gold standard for diagnosis. A doctor takes a small sample of bone marrow, usually from the hip bone, to examine under a microscope. In aplastic anaemia, the marrow will appear hypocellular, meaning it is empty and contains mostly fat, with very few blood-forming cells.
Ruling Out Other Conditions
Other tests may be performed to rule out inherited forms or other causes of pancytopenia.
Aplastic Anaemia Treatment: From Supportive Care to a Cure
Treatment depends on the severity of the condition and the patient's age and overall health. The goal is to restore bone marrow function.
Supportive Care: Managing Symptoms
This isn't a cure but is essential for keeping patients stable and preventing complications.
• Blood Transfusions: These provide temporary relief by boosting red blood cell and platelet counts.
• Medications (Antibiotics, Antifungals): These are used to prevent and treat infections in patients with low white blood cell counts.
Immunosuppressive Therapy (IST)
For patients who are not candidates for a transplant or have less severe disease, IST is a primary treatment. It uses drugs like antithymocyte globulin (ATG) and cyclosporine to suppress the immune system and stop it from attacking the bone marrow, allowing it to recover.
Bone Marrow Transplant (BMT) / Stem Cell Transplant
For younger patients with a matched sibling donor, a BMT is the preferred treatment and offers the best chance for a permanent cure for aplastic anaemia. It involves replacing the diseased bone marrow with healthy stem cells from a donor.
Emerging Therapies and Clinical Trials
Newer drugs, like eltrombopag, are showing promise in stimulating bone marrow growth, especially when combined with IST. Access to clinical trials can be an option for some patients.
Living with Aplastic anaemia: Prognosis and Management
Learn how to live with aplastic anaemia, including its prognosis, treatment options, and tips for effective long-term management.
Understanding Your Prognosis
The outlook has improved dramatically over the past few decades. With modern treatment options for bone marrow failure, survival rates are high. Outcomes are best for those who receive a bone marrow transplant from a matched sibling donor. For others on IST, many achieve long-term remission, though relapse can occur.
Lifestyle Adjustments and Self-Care
Living with aplastic anaemia requires vigilance:
• Infection Prevention: Practice meticulous hand hygiene, avoid crowds, and stay up-to-date on vaccinations (as advised by your doctor).
• Avoid Injury: Be cautious to avoid cuts and bruises due to low platelets.
• Rest: Listen to your body and get plenty of rest to combat fatigue.
• Support System: Seek support from family, friends, and patient advocacy groups.
Conclusion
A diagnosis of aplastic anaemia is undeniably serious, but it is crucial to frame it with hope. Modern medicine has transformed it from a universally fatal disease to a highly treatable condition. The journey involves understanding the subtle signs of severe aplastic anaemia, obtaining an accurate diagnosis, and accessing specialised care from a haematologist. Whether through a transplant that offers a cure or immunosuppressive therapy that induces long-term remission, there are effective paths forward. If you recognize these symptoms in yourself or someone you care about, take action. With timely intervention, patients can not only survive but also go on to live full, active lives.
Consult a Haematologist for the best advice
Consult a Haematologist for the best advice
Dr. Thorana Prakash M
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Sumanth R
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Purvi Kadakia Kutty
Paediatric Haematologist
10 Years • MD Paediatrics FNB Pediatric Haem. & Onco.
Mumbai
Apollo Hospitals CBD Belapur, Mumbai
Dr Abilash Jain
General Physician/ Internal Medicine Specialist
12 Years • MBBS,DNB(FM),MNAMS,FIAMS,CCGMG(GERIATRICS),DGM (GERIATRICS),PGCD(DIABETES,BOSTON UNIVERSITY),FID(DIABETICS UK)CCEPC(PALLIATIVE CARE),CCCC(CRITICAL CARE)
Visakhapatnam
Apollo Clinic Vizag, Visakhapatnam
Dr. Ramalinga Reddy
General Physician
5 Years • MBBS MD General medicine
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Consult a Haematologist for the best advice
Dr. Thorana Prakash M
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Sumanth R
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Purvi Kadakia Kutty
Paediatric Haematologist
10 Years • MD Paediatrics FNB Pediatric Haem. & Onco.
Mumbai
Apollo Hospitals CBD Belapur, Mumbai
Dr Abilash Jain
General Physician/ Internal Medicine Specialist
12 Years • MBBS,DNB(FM),MNAMS,FIAMS,CCGMG(GERIATRICS),DGM (GERIATRICS),PGCD(DIABETES,BOSTON UNIVERSITY),FID(DIABETICS UK)CCEPC(PALLIATIVE CARE),CCCC(CRITICAL CARE)
Visakhapatnam
Apollo Clinic Vizag, Visakhapatnam
Dr. Ramalinga Reddy
General Physician
5 Years • MBBS MD General medicine
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
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Frequently Asked Questions
1. Is aplastic anaemia a form of cancer?
No, aplastic anaemia is not cancer. However, it is a serious bone marrow failure disorder, and some treatments, like immunosuppressive therapy, are similar to cancer treatments. Untreated severe aplastic anaemia can increase the risk of developing leukemia.
2. What is the difference between aplastic anaemia and leukemia?
In leukemia, the bone marrow is overactive and produces large numbers of abnormal, cancerous white blood cells. In aplastic anaemia, the marrow is underactive and empty, failing to produce enough of any healthy blood cells.
3. Can aplastic anaemia be cured?
Yes, a bone marrow transplant from a matched donor, often a sibling, can be a permanent cure. For others, immunosuppressive therapy can lead to long-term remission, which is effectively a functional cure, though relapse is possible.
4. What is the life expectancy for someone with aplastic anaemia?
Life expectancy has greatly improved. With successful treatment, such as a transplant or effective IST, many patients have a normal or near-normal life expectancy. Outcomes depend on age, severity, and response to treatment.
5. Is aplastic anaemia hereditary?
Most cases are acquired and not hereditary. However, a small percentage of cases are caused by inherited genetic syndromes like Fanconi anaemia, which can run in families.