Aplastic anemia

1. Big picture

Aplastic anemia is a bone marrow failure syndrome in which the marrow becomes empty/fatty and hypocellular, causing pancytopenia:

↓ red cells → anemia ↓ white cells, especially neutrophils → infections ↓ platelets → bleeding

The exam pattern is:

fatigue + infections + petechiae/bleeding + pancytopenia + very low reticulocytes + hypocellular fatty bone marrow → aplastic anemia.

The central idea:

In aplastic anemia, the problem is not destruction of mature blood cells; the problem is that the marrow cannot produce them.

The Debrecen hematology textbook describes aplastic anemia as hypocellular bone marrow with reduced multipotent and CD34+