Abstract

APLASTIC ANEMIA: TREATMENT OPTIONS IN PUBLIC SECONDARY HEALTH CARE SET-UP

Deepa Lakshmi M, Smruthy Ann Mathew, Nicy Joy, Arun K. P*

ABSTRACT

Aplastic anemia, an unusual hematologic disease, is the paradigm of the human bone marrow failure syndromes.[1] Aplastic anemia is not a type of cancer but may be associated with certain types of cancers or cancer treatments. Aplastic anemia may be inherited or acquired. Inherited aplastic anemia is caused by abnormal copies of genes, gene mutation that is passed on from parents to their offspring. Inherited bone marrow failure syndromes (BMFS) those increase the risk of aplastic anemia include Fanconi anemia, dyskeratosis congenita, Shwachman- Diamond syndrome of which Fanconi anemia is the most common one.[2] Acquired aplastic anemia can be triggered by a drug, exposure to toxic chemicals or infection with some types of viruses. The most commonly accepted pathogenesis is that these agents trigger an abnormal immune reaction where T-lymphocytes start producing Cytokines in excess amounts which kill bone marrow cells in some individuals.[2] In about 85% of cases, no cause is identified.[3] The incidence of aplastic anemia in west is 2 per million and is about 2 to 3 folds high in Asia.[1] An Indian pediatric study reported the incidence of 6.8 per million in the year 2006 which was found to be higher than many western countries viz. France, Brazil, UK, and United States of America but lower than Sweden and China.[3]

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