Aplastic anemia: is it serious?
In the episode of the series Nina, Jeremy, 25, explains that he suddenly “has the impression of being 80 years old” and of being unable to get up in the morning because of his fatigue.
His blood count (or blood count) shows a anemia severe and has a hemorrhagic syndrome (bleeding).
Doctors diagnose a global aplastic anemia, a blood disease that results in a depletion of the bone marrow which can no longer produce the stem cells that make up red blood cells, white blood cells and platelets.
It is a rare disease with an incidence of less than ten cases per million per year, which is twenty times less than the multiple myeloma and ten times less than leukemia acute.
Who are the people at risk?
Medullary aplasia (MA) mainly affects young people aged 15 to 29, with another peak in incidence after 50 years. The disease can be congenital (this is called Fanconi anemia) or it can be due to exposure to toxic agents: medicinal or environmental or occupational. In Jeremy’s case, the illness is due to occupational exposure to radiation.
How is it treated?
Treatment consists of bone marrow transplant or immunosuppressive treatment (ciclosporin or antilymphocyte serum).
The choice between immunosuppression and transplant depends on whether or not there is a HLA-genoidentical donor (the siblings, the severity of the disease and the patient’s age. According to the recommendations of the Haute Autorité de santé, the treatment options are as follows:
• the marrow transplant is the standard treatment for severe AM in patients under 45 years of age who have an identical HLA donor from their siblings
• immunosuppressive treatment with SAL + ciclosporin is to be preferred in the most severe forms, or in older patients or in patients who do not have a sibling donor.
Treatment of moderate forms of aplastic anemia
These moderate forms of the disease sometimes require simple monitoring. The reference treatment for non-severe forms in young subjects (less than 50 years old) is the combination SAL + ciclosporin. Older patients can be treated with cyclosporin alone, or with androgens.
Source : High Authority for Health (HAS)
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