My short seminar :) collection from several websites & Lecz give U simple, short, nice info. about Aplastic anemia

1. Aplastic Anemia

2. Definition
• Pancytopenia resulting from aplasia of the B.M.
• classified into primary and secondary types.

3. Definition
• the bone marrow
produces too few of all
three types of blood
cells: red cells, white
cells, and platelets
(pancytopenia)

4. Causes
• A-Primary:
1- congenital (as Fanconi's anemia).
2- Idiopathic acquired (67% of cases).

5. Causes
• B- secondary:
1-chemicals (benzene, toluene, glue sniffing).
2-drugs (chemotherapeutics, antibiotics, gold, phenytoin).
3-insecticides.
4-ionizing radiation.
5-infections (as hepatitis).
6-paraxysmal nocturnal haemoglobinuria.

6. Pathogenesis
Reduction in the number of haemopoietic pluripotential stem cells
-------> fault in the remaining stem cells
OR
Immune reaction against stem cells.
-------> unable to divide and differentiate sufficiently to produce the
blood cells.

7. Clinical Features
• Anemia with malaise, pallor and other associated
symptoms such as palpitations.
• Thrombocytopenia (low platelet counts), leading to
increased risk of hemorrhage, bruising and petechiae.

8. Clinical Features
• Leukopenia (low white blood cell count), leading to
increased risk of infection.
• Reticulocytopenia (low reticulocyte counts).
• Occurs at any age.
• Male predominance.

9. Diagnosis
• 1- Complete Blood Picture
(CBP): which shows
pancytopenia and
reticulocytes.
• 2-Bone marrow aspirate:
Markedly hypocellular
marrow, due to
replacement of
hemopoietic marrow by
adipose tissue (not fibrosis
or neoplastic cells).

10. THERAPY
1-General:
• The cause is removed.
• Supportive care with blood Transfusion, plts
concentrate.
• Prevention of infection.

11. THERAPY
2. Specific:
A-BONE MARROW
TRANSPLANTATION:
• Treatment of choice.
• from HLA matched donor.
Usually siblings.
• Long term survival rates:
60-70%.

12. THERAPY
A-IMMUNOSUPPRESSION: by using drugs
• Antithymocyte globulin (ATG)
• Antilymphocyte glubulin (ALG)
• Cyclosporin
• Intensive immunosupression : cyclophosphamide
• Corticosteroids.

13. FANCONI ANEMIA
• Fanconi’s anemia is inherited as an autosomal recessive.
• Associated with skeletal, skin, renal and central nervous
system abnormalities.
• It usually presents between the ages of 5 and 10 years.
• Treatment with androgens and SCT