High-risk indications for patients with congenital aplastic anemia

Bleeding, anemia, and recurrent fever and infection are the main clinical symptoms of patients with aplastic anemia. Although aplastic anemia is not a malignant disease, if left untreated, its harmfulness is second only to leukemia. So what are the clinical symptoms of this disease?

Clinical symptoms of aplastic anemia:

1. Anemia

The patient may experience dizziness, fatigue, and confusion. Blood examination will show a decrease in three series, namely, a decrease in white blood cells, platelets, and hemoglobin. Therefore, those with a decrease in the three lineages should be highly alert to aplastic anemia.

2. Susceptible to infection

The patient has a decrease in leukocytes and weakened immunity, making him susceptible to infection, which is often manifested by fever. Patients with aplastic anemia are prone to repeated infections, so special care should be taken.

3. Bleeding

It may manifest as bleeding gums, often with a bloody mouth; bleeding of the skin and mucous membranes. Severe patients may experience gastrointestinal bleeding, hematuria, fundus hemorrhage (often accompanied by visual impairment) and intracranial hemorrhage.

Therefore, aplastic anemia is not without traces. By paying attention to some clues, you can detect the disease as early as possible.

What are the high-risk indications for aplastic anemia?

About 5% to 10% of patients with congenital aplastic anemia eventually develop acute leukemia, mostly of the myeloid type. Patients with obvious skin changes are usually not accompanied by renal malformations, but may eventually transform into squamous cell carcinoma or other malignant tumors.

The prognosis of acquired aplastic anemia varies depending on the cause. For aplastic anemia caused by a specific reaction to chloramphenicol or infectious hepatitis, the prognosis is extremely poor, while that caused by an overdose of chloramphenicol can usually be recovered.

The high-risk indications for aplastic anemia are rapid onset, severe bleeding, platelet count <20,000/mm3, granulocyte count <500/mm3, extremely low or absent reticulocytes; bone marrow proliferation is significantly low, with lymphocytes and non-hematopoietic cells being the main cells; more than 50% of such children die within a few months of onset of the disease from infections or bleeding such as staphylococcal sepsis or Pneumocystis carinii. The disease progresses slowly, the granulocyte and thrombocytopenia is not severe, the bone marrow involvement is mild, and the patient responds to androgen therapy, with a good prognosis. The long-term survival rate after bone marrow transplantation can reach 30% to 60%.