Aplastic anaemia is a rare, potentially life-threatening bone-marrow failure syndrome characterised by pancytopenia, a reduction in red cells, white cells, and platelets, arising from hypoplasia or aplasia of haematopoietic tissue in an otherwise non-infiltrated, hypocellular marrow. The disorder reflects damage to …
Aplastic anaemia is a rare, potentially life-threatening bone-marrow failure syndrome characterised by pancytopenia, a reduction in red cells, white cells, and platelets, arising from hypoplasia or aplasia of haematopoietic tissue in an otherwise non-infiltrated, hypocellular marrow. The disorder reflects damage to or loss of pluripotent haematopoietic stem and progenitor cells. Most cases are acquired and immune-mediated, in which autoreactive T lymphocytes suppress haematopoiesis; others follow exposure to drugs, toxins, radiation, or viral infection, while inherited forms such as Fanconi anaemia result from defined genetic defects. Clinical features stem from the cytopenias and include fatigue and pallor from anaemia, recurrent or severe infection from neutropenia, and bleeding from thrombocytopenia. Diagnosis rests on the peripheral blood count and on bone-marrow aspiration and trephine biopsy demonstrating reduced cellularity, with additional testing to exclude infiltrative, dysplastic, and inherited causes. Management depends on disease severity and patient age and encompasses supportive transfusion and infection control, immunosuppressive therapy, and allogeneic haematopoietic stem-cell transplantation, which can be curative in suitable candidates. Accurate distinction from other causes of pancytopenia and immune cytopenias is essential to guide treatment and prognosis in this haematological condition.
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