Pathophysiology

Predisposing Factors: Precipitating Factors:

•
•

Damage to the microenvironment

of the marrow

Altered bone marrow function

Reduced hematopoiesis

- fatigue
- dizziness Anemia Leukopenia Thrombocytopenia
- shortness
of breath
- pale skin
- bruising
- oral thrush

APLASTIC
ANEMIA
If Treated: If Not Treated:
Medical management Pancytopenia relapse
• Blood transfusion
- Pack RBC RBC platelet WBC
- Platelet concentrate
Hypoxemia hemorrhage localized infection
• Bone Marrow
Transplantation (BMT)
Hypoxia hypovolemic systemic infection
• Peripheral Blood Stem Shock
Cell Transplantation Anoxia septic shock
(PBSCT)
Immunosuppressive Therapy DEATH
• Antithymocyte Globulin
• Cyclosporine

Supportive theraphy

• IVF Therapy
• Drug Theraphy
Written Pathophysiology

Aplastic anemia is a rare disease that can either be congenital or acquired, but most
cases are idiopathic or no apparent cause. This is caused by a decrease in or damage to
marrow stem cells, damage to the microenvironment within the marrow and replacement of
the marrow with fat. Some factors that can trigger it are exposure to chemicals and radiation
(benzene, pesticides) and infection. It results in bone marrow failure, which eventually alters
the normal functioning of the bone marrow, which is to produce Red Blood Cells. As a result,
there will be decreased production of red blood cells, which most probably lead to anemia
(decreased RBC count), leukopenia (less than normal amount of WBC in the circulation) and
thrombocytopenia (decreased platelet count). If this condition will not be treated,
pancytopenia then relapses. As an effect, presence of abnormal decrease in RBC will lead
anoxia. Platelet will also decrease which could possibly lead to hemorrhage then to
hypovolemic shock. Moreover, there is also abnormal decrease in WBC which in return can
lead to localized infection then to systemic infection after sometime that it is not treated, will
progress to septic shock that eventually lead to death. Since there is impairment in the
production of RBCs, WBCs and platelet, aplastic anemia can be manage through blood
transfusions and can be treated through Bone Marrow Transplantation (BMT) and Peripheral
Blood Stem Cell Transplantation (PBSCT). In others the disease can be managed with
immunosuppressive therapy; a combination of Antithymocyte Globulin and Cyclosporine is
most commonly used. Supportive therapy plays an important role in the management of
aplastic anemia. The patient is supported with transfusions of RBC and platelet as necessary.