Medullary aplasia

What is marrow aplasia?

Medullary asplasia is a marrow failure characterized by a total (severe aplasia) or partial (moderate aplasia) disappearance of hematopoietic precursors (cells) in the bone marrow, which will result in peripheral blood pancytopenia, usually accompanied by anemic, infectious and hemorrhagic syndrome.

It is a rare disease that causes the patient to be highly susceptible to infectious diseases.

Medullary aplasia affects the number of blood cells, making the patient more vulnerable to infectious diseases.

Prognosis of the disease

The prognosis of bone marrow aplasia depends on several factors, such as the severity of the aplasia, the age of the patient and early diagnosis. In many cases it is a serious disease that requires a bone marrow transplant to be cured.

Symptoms of bone marrow aplasia

The symptoms depend on the intensity of the deficit of cells in the blood. Thus, this deficit can manifest itself with

  • Fatigue
  • Weakness
  • Pallor
  • Dizziness
  • Palpitations
  • Headache

Likewise, as a consequence of leukocyte deficiency, oral ulcers and repeated infections may occur. In addition, platelet deficiency can also cause

  • Bruising after minor trauma
  • Bleeding of the gums, nose or conjunctivae.
  • Bleeding in other parts of the body, more severe.

Medical tests for bone marrow aplasia

Bone marrow aplasia is initially detected by hemogram, a diagnostic test in which a deficit in the amount of hematopoiesis, platelets and leukocytes is observed. In view of these irregularities, a bone marrow biopsy will be performed, which will determine the diagnosis of bone marrow aplasia and assess the degree or severity of this.

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What are the causes of spinal cord aplasia?

The causes of bone marrow aplasia can be congenital or acquired:

  1. Congenital. Congenital causes include:
  1. Fanconi’s anemia
  2. Schwachmann-Diamond syndrome, with pancreatic insufficiency, metaphyseal dysplasia and hypoplastic neutropenia.
  3. Aplasia due to dyskeratosis congenita.
  1. Acquired, including:
  1. Idiopathic, with no apparent cause.
  2. Secondary. Caused by ionizing radiation, drugs, chemicals, seronegative hepatitis or other viruses (HIV, among others).
  3. Paroxysmal nocturnal hemoglobinuria.

Can it be prevented?

The best way to prevent bone marrow aplasia is to perform periodic blood tests to check the quantity and condition of blood cells.

Treatments for bone marrow aplasia

The main treatment is to find out and eliminate the cause of the aplasia, whenever possible. On the other hand, whatever the therapeutic alternative, it is important to start treatment as soon as possible, since the patient’s favorable response and survival will also depend on this.

Treatments may include:

  1. Blood transfusions with hematite and platelet concentrates, to treat anemia.
  2. Immunosuppressive treatment (TIS) with drugs.
  3. Bone marrow transplantation from an HLA-identical sibling.
  4. Allogeneic Bone Marrow Transplantation (Allogeneic Bone Marrow Transplant) from an alternative donor to the HLA-identical sibling.

Which specialist treats it?

The hematologist specialist is in charge of the diagnosis and treatment of blood diseases, and therefore of bone marrow aplasia.