Aplastic anemia

Aplastic anemia is a disease characterized by deep depression of bone marrow hematopoiesis, weakened proliferation and delayed maturation of bone marrow elements with the development of pantito-singing. Allocate forms with the defeat of all three germs of hematopoiesis( aplastic anemia) and with a predominant disturbance of erythropoiesis with relatively preserved leuko- and thrombocytopoiesis( partial form, red cell aplasia).

Usually the disease develops gradually. The picture of peripheral blood is characterized by pancytopenia: anemia, more often normochromic, less often( 20-22%) - hyperchromic;thrombocytopenia;leukopenia due to a decrease in the number of granulocytes with relative lymphocytosis [Romanova AF.et al., 1997].Some patients at the onset of the disease sometimes increase MCV( more than 100 fl), which can lead to the assumption of vitamin B12 and folic deficiency anemia. This question can be solved by the results of a study of red bone marrow. Characteristic signs of severe aplastic anemia include: the number of leukocytes less than 0.5x109 / l, platelets less than 20x109 / l, reticulocytes below 10x109 / l( less than 0.1%);survival in these patients is 3-6%,

for a less severe form, it is much higher [Wood MA, Bann PA, 1997].It is very important to identify patients with a very severe form of aplastic anemia, because they need to start treatment with aggressive methods as soon as possible.

In the punctate of the red bone marrow in aplastic anemia, a decrease in the number of myelokaryocytes( erythrocyte and granulocyte series) is revealed, until their complete disappearance, with a delay in the maturation of these cells. The reduction of megakaryocytopoiesis is noted. The most pronounced lesion of the erythroid sprout. In severe cases, a significant decrease in the content of nuclear elements with the inhibition of erythropoiesis, granulocytopoiesis and megakaryocytopoiesis is observed, up to complete devastation of the red bone marrow. To obtain a bone marrow puncture in patients with aplastic anemia, in some cases it is necessary to use three points, since even with a severe form of the disease, the patient may have "hot pockets" of hematopoiesis.