Aplastic Anemia: Biology and Treatment

Abstract

Aplastic anemia is characterized by decreased bone marrow function with inadequate production of erythrocytes, granulocytes, and platelets. Marrow failure may be caused by absence of or defects in hematopoietic stem cells, abnormalities of the bone marrow microenvironment, ineffective cell-to-cell interactions, or immune disorders. Although most patients with aplastic anemia have normal immunity, some have abnormalities of T- and B-lymphocytes. Rare patients have an immune cause of marrow failure. Treatment of aplastic anemia involves blood transfusions and withdrawal of potential causal factors. Efforts to stimulate hematopoiesis with androgens, corticosteroids, and other drugs have been largely unsuccessful. Some patients may recover after treatment with antithymocyte globulin or other immunosuppressive agents. Bone marrow transplantation is the preferred treatment for patients with severe aplastic anemia who have a human-leukocyte-antigen-identical related donor. Transplants of hematopoietic stem cells obtained from alternative sources, such as fetal liver cells or stem cells from long-term, in-vitro cultures, also may be useful.

A ação do decanoato de nandrolona (Deca-durabolin®) sobre parâmetros hematológicos e proteína total plasmática de ratos (Rattus rattus) com depressão medular induzida após administração de sulfato de vincristina (Oncovin®)

“…Pode ser utilizado na regeneração de diversos tecidos, como o sangüíneo, córneo e outros (LARSSON et al, 2002). Outros medicamentos estimulantes da medula óssea utilizados são o ácido all-trans-retinóico (Vesonoid ® ) (PALLOTA et al, 2000), a oximetolona (Hemogenin ® ) e a timomodulina (Leucogen ® ), cuja eficácia para os animais domésticos, é pouco estudada (GALE et al, 1981). CABRERA et al (1996) relataram um caso em que a timomodulina foi administrada juntamente com outros imunoterápicos específicos, em criança portadora de neutropenia cíclica.…”

Minor histocompatibility antigen H-Y is expressed on human hematopoietic progenitor cells.

“…Allogeneic bone marrow transplantation (BMT)' is being successfully used for the treatment of various hematological disorders, such as aplastic anemia (1,2) and leukemia (3,4). However, graft-versus-host disease (GVHD) (5,6) and graft failure (7,8) are major obstacles to successful transplantation, causing serious morbidity and mortality.…”

Successful desensitization to antithymocyte globulin in a child with aplastic anemia

“…( A plastic anemia was first described in 1888, and since then there have been between 500 and 2500 cases of the disease reported each year. 1 Characterized by bone marrow aplasia and peripheral blood pancytopenia, aplastic anemia is considered to be an immune-mediated bone marrow disease. 2 The pathophysiology of aplastic anemia is thought to be an autoimmune attack by T lymphocytes against the bone marrow.…”