Background

Aplastic anemia is a syndrome of bone marrow failure characterized by peripheral pancytopenia and marrow hypoplasia. Mild macrocytosis is observed in association with stress erythropoiesis and elevated fetal hemoglobin levels. Paul Ehrlich introduced the concept of aplastic anemia in 1888 when he studied the case of a pregnant woman who died of bone marrow failure. However, it was not until 1904 that Anatole Chauffard named this disorder aplastic anemia. (See Etiology.) Go to Anemia, Chronic Anemia, Megaloblastic Anemia, Myelophthisic Anemia, Hemolytic Anemia, and Sideroblastic Anemias for complete information on these topics.

Complications
Complications of aplastic anemia include infections and bleeding. (See Prognosis.) Complications of bone marrow transplantation (BMT), used in the treatment of aplastic anemia, include graft versus host disease (GVHD) and graft failure. (See Treatment.)

Staging
Staging of aplastic anemia is based on the criteria of the International Aplastic Anemia Study Group, as follows:
y y

Blood - Neutrophils less than 0.5 X 109/L; platelets less than 20 X 109/L; reticulocytes less than 1% corrected (percentage of actual hematocrit [Hct] to normal Hct) Marrow - Severe hypocellularity; Moderate hypocellularity, with hematopoietic cells representing less than 30% of residual cells

Severe aplasia is defined as including any 2 or 3 peripheral blood criteria and either marrow criterion. A further subclassification developed after the recognition that individuals with neutrophil counts lower than 0.2 X 109/L had very severe aplastic anemia (VSAA). This group is less likely than others to respond to immunosuppressive therapy.