Aplastic anaemia is a rare but serious blood disorder seen in Malaysia. Learn about causes, symptoms, diagnosis, treatment options, diet, and living safely.
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Overview
What is aplastic anaemia?
Aplastic anaemia is a condition where the bone marrow fails to produce enough blood cells:
- Red blood cells, which carry oxygen
- White blood cells, which fight infection
- Platelets, which help control bleeding
As a result, patients develop low blood counts in all three cell types.
Who is affected in Malaysia?
- Can affect children, young adults, and older adults
- Seen in all ethnic groups
Causes and Risk Factors
Why does it happen?
In most Malaysian patients, the immune system mistakenly attacks the bone marrow. Possible triggers include:
- Viral infections such as hepatitis or dengue
- Certain medications or chemotherapy
- Exposure to pesticides, solvents, or industrial chemicals
- Previous radiation therapy
- Pregnancy (uncommon)
- Unknown cause, which is the most common
Who is more at risk?
- Patients with autoimmune diseases
- Those with significant chemical exposure at work
- Patients treated previously with chemotherapy
- Rare inherited conditions in children
Symptoms
Common symptoms include:
- Tiredness, weakness, breathlessness
- Frequent infections or prolonged fever
- Easy bruising or bleeding
- Nosebleeds or bleeding gums
- Heavy menstrual periods in women
- Pale skin
Symptoms may develop gradually or appear suddenly.
Diagnosis
How is it diagnosed in Malaysia?
Diagnosis is done through blood tests and a bone marrow examination, usually in a hospital setting.
Common tests
- Full blood count showing low white cells, red cells, and platelets
- Reticulocyte count, usually low
- Bone marrow biopsy showing very low cellularity
- Viral screening, including hepatitis tests
- Additional tests to rule out inherited or autoimmune causes
Treatment Options
Treatment depends on severity, age, and donor availability.
Supportive care
- Blood transfusions when haemoglobin is low
- Platelet transfusions to prevent bleeding
- Prompt antibiotics for infections
Immunosuppressive therapy
Commonly used in Malaysia when transplant is not immediately suitable:
- Anti-thymocyte globulin (ATG)
- Cyclosporine
- Sometimes eltrombopag to help stimulate bone marrow recovery
These treatments are available in major public hospitals and selected private centres.
Stem cell (bone marrow) transplant
- The best chance for cure, especially in younger patients
- Requires a suitable donor, often a sibling
- Performed in specialised transplant centres
New and advanced treatments
- Improved transplant techniques
- New immune-based therapies
- Selected patients may be offered clinical trials
Dietary Advice
What to eat
- Home-cooked, well-cooked food
- Rice, noodles, chapati with properly cooked dishes
- Well-cooked chicken, fish, eggs, and dhal
- Fruits that are washed well and peeled
- Adequate fluids
What to avoid
- Raw seafood, raw eggs, half-cooked meat
- Unpasteurised milk or soft cheeses
- Food from unhygienic stalls if white cells are low
- Herbal or traditional medicines without doctor approval
Supplements
- Do not take iron, herbs, or supplements unless advised
- Some traditional remedies may worsen the condition or interfere with treatment
Living with Aplastic Anaemia
Daily precautions
- Avoid crowded places if white cell count is low
- Wash hands frequently
- Wear a mask if advised by your doctor
- Avoid activities with risk of injury if platelets are low
Exercise and lifestyle
- Light walking is encouraged if feeling well
- Avoid strenuous exercise when counts are low
- Adequate rest is important
Follow-up
- Regular blood tests are essential
- Long-term monitoring is needed even after recovery
Emotional support from family and patient support groups can be very helpful.
FAQs
Is aplastic anaemia cancer?
No. It is not cancer and does not spread like cancer.
Is it curable?
Some patients are cured with stem cell transplant. Others do very well with medication.
Is it contagious?
No. It cannot be passed to others.
Can I continue working?
This depends on your blood counts and type of work. Discuss this with your doctor.
When to Contact a Doctor Urgently
Go to the emergency department or contact your doctor if you have:
- Fever 38°C or higher
- Bleeding that does not stop
- Black stools or blood in urine
- Severe shortness of breath or weakness