by Bearden M


Anemia is a low level of healthy red blood cells (RBCs). RBCs carry oxygen from the lungs to the rest of the body. When RBCs are low, the body does not get enough oxygen.

Aplastic anemia is a type of anemia caused by problems with bone marrow. It is a rare condition. For some, it can be life-threatening.

Location of Active Bone Marrow in an Adult
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Blood cells start as stem cells in the bone marrow. Aplastic anemia is caused by damage to these stem cells. The damaged cells cannot grow as RBCs and levels in the body begin to drop. It is believed this happens in most because of an immune system problem. Sometimes drugs, viruses, or toxins may play a role.

Aplastic anemia can also be caused by genetic issues.

Risk Factors

The risk of aplastic anemia is higher in those who are:

  • Exposed to certain toxins that can be in gas, paint, oil and coal emissions, and industrial solvents
  • Getting high-dose radiation and chemotherapy treatments
  • Infected with certain viruses
  • Taking certain medicine such as antibiotics
  • Taking some illegal drugs
  • Taking medicine used to treat rheumatoid arthritis
  • Diagnosed with bone marrow diseases
  • Pregnant


Aplastic anemia may cause:

  • Fatigue or weakness
  • Shortness of breath with activity
  • Rapid heart rate
  • Pale skin or skin rash
  • Easy bruising
  • Nosebleeds, bleeding gums or cuts that bleed for a long time
  • Fever
  • Shortened attention span


You will be asked about your symptoms and past health. A physical exam will be done. Blood tests will show the level of RBCs. A bone marrow biopsy will also be done. It will show where the problems are starting and rule out other problems.

Other tests may be needed to look for a cause.


The goal of treatment is to raise the amount of RBCs in the blood. How this is done depends on what is causing the aplastic anemia. Medicines or chemical or radiation exposures causing the anemia may be stopped or reduced.

Treatment for aplastic anemia from other causes may include:

Blood Transfusions

Healthy blood from a donor can quickly replace red blood cells. It can help relieve symptoms for a short time. It is not a cure. Once those blood cells wear down, the anemia will occur again.

Immune Suppressing Medicine

Medicine may be given to change or slow the immune system. It can help if stem cell damage is caused by immune system problems. Slowing the immune system will give bone marrow time to recover. It should then be able to make red blood cells again. Steroids may also be given with this medicine.

Bone Marrow Transplantation

Badly damaged bone marrow may need to be replaced. Donated healthy bone marrow should be able to make healthy RBCs again.


Most cases of aplastic anemia cannot be prevented.

For others, limit exposure to toxins when possible. Be careful when you are around things like gas, paint, oil, coal emissions, and industrial solvents.


Aplastic Anemia and MDS International Foundation 

National Heart, Lung, and Blood Institute 


Aplastic Anemia and Myelodysplasia Association of Canada 

The College of Family Physicians of Canada 


Aplastic anemia and pure red cell aplasia. EBSCO DynaMed website. Available at: Accessed May 13, 2022.

Explore aplastic anemia. National Heart, Lung, and Blood Institute website. Available at: Accessed May 13, 2022.

Killick S.B., Bown N., et al; British Society for Standards in Haematology. Guidelines for the diagnosis and management of adult aplastic anaemia. Br J Haematol, 2016; 172(2): 187-207.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 03/2022
  • Update Date: 05/13/2022