Aplastic anaemia

Question 1

What is aplastic anaemia?

Answer 1

Aplastic anaemia (AA) is defined by pancytopenia with hypocellular marrow and no abnormal cells.

At least 2 of the following peripheral cytopenias must be present: haemoglobin <100 g/L (<10 g/dL), platelets <50 × 10⁹/L, absolute neutrophil count <1.5 × 10⁹/L.

Question 2

What are the risk factors for aplastic anaemia?

Answer 2

> Drug or toxin exposure
> Paroxysmal nocturnal haemoglobinuria
> Recent hepatits
> Pregnancy 
> Autoimmune disease
> Family history

Question 3

What are the signs and symptoms of aplastic anaemia?

Answer 3

> Recurrent infections
> Fatigue
> Pallor
> Bleeding/ easy bruising
> Tachycardia
> Dyspnoea
> Persistent warts

Question 4

What is the epidemiology of aplastic anaemia?

Answer 4

The incidence of acquired AA is about 2 per million population per year in North America and Europe.

There is no gender imbalance. Patients can be affected at any age, although there is a biphasic age distribution with peaks from 10 to 25 years and >60 years.

Question 5

What investigations do you do for aplastic anaemia?

Answer 5

> FBC- pancytopenia
Reticulocyte- low
Bone marrow biopsy and cytogenetic analyses- hypocellular marrow with no abnormal cell population