This is a very serious life-endangering form of anemia due to a reduced activity of the bone marrow and its failure to produce normal red cells and platelets. This causes a reduction in the number of cells in the blood, particularly the important granulocytes (those that destroy germs, the phagocytes).
There are many causes. Sad to say, some are drug-induced, and include the use of many important drugs in everyday medical treatment. Why some patients respond adversely to these is still an enigma, and there seems no relationship between the drug dosage and the reaction of the bone marrow.
Probably the best known reactions are those occurring in some from chloramphenicol, an antibiotic used widely in the 1950-60 era. But anemia may also occur during medication with the sulfa drugs. Some anti-epileptic drugs can have a similar effect, and drugs used in the treatment of rheumatoid arthritis (mainly the non-steroidal anti-inflammatory drugs, known as NSAIDs, and gold) have been similarly incriminated.
Antithyroid drugs (methylthiouracil), various industrial chemicals, insecticides, aniline dyes and hair dyes have also been implicated.
A major upheaval occurred in the hair dye industry during the late 1 9 70s when evidence implicating dyes was put forward. This was worsened when certain researchers claimed there could be a more sinister relationship that may extend to causing cancer in some susceptible people.
In some cases, the plastic anemia that develops may continue and recovery does not take place.
However, various other causes have been cited. Anemia may occur following infections, particularly relatively simple ones like infectious hepatitis.
Fortunately, some may respond well to hormonal therapy. In some rare cases there is a genetic factor that indicts the patient. In others it may occur for no apparent reason, and these are given the name “idiopathic” – this simply means the doctors cannot pick the cause.
Hypoplastic Bones Symptoms
The symptoms are similar to those seen in leukemia. Infections are common, as the white cells that normally destroy germs may occur, due to the lack of platelets, and there will be general symptoms of anemia, as the red cell numbers diminish.
Hypoplastic Bones Treatment
This is a difficult condition to treat. Careful history-taking may indicate one of the known causes and, if present, exposure to any particular drug or chemical will be stopped at once. Infections must be vigorously treated before they gain a substantial foothold. Hemorrhages must be checked either by giving transfusions or special platelet transfusions, and trauma must be prevented, for it could cause added blood loss through hemorrhage.
Corticosteroids and hormones have varying success rates. Often medication must be continued for many months. In recent times a major step forward has been made by the use of bone-marrow transplants. This is now carried out in most Western lands with relatively high success figures. It seems to be the method of choice in suitable patients, and the future therapy lies in this direction. It has many problems to overcome, and careful patient selection is one of them, but these are being competently handled.
Until the advent of this form of therapy, between 10 and 20 percent of patients recovered and then rested before dying, often rapidly. Some lived on, receiving regular support from intensive drug therapy and blood transfusions. Often overwhelming infections caught up with them, and produced their demise.