文档介绍：Aplastic Anemia (AA) Zhongshan Hospital ,Fudan University Zou Shanhua
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Outline
Bone marrow hematopoiesis failure led by chemicals, radiation, biological factors and unknown etiology.
mon clinical presentation is mild to severe pancytopenia.
Epidemiology
The incidence rate of AA : per 100,000,
AAA : per 100,000,
CAA : per 100,000.
Distribution:most AA patients are young and middle-aged people, male more than female
Etiology
Primary AA:unknown causes,about 60~70%
Secondary AA
Etiology of Secondary AA
Chemicals
Drug: antibiotics, antineoplastic
agent, NSAIDs
Other chemicals:
benzene and benzene derivatives,
arsenic, heavy metals,insecticides
Etiology of Secondary AA
Radiation
Viral infection:Hepatitis virus, EBV
Mechanism
Hematopoietic stem cell defect
Stem cells count decrease
Stem cells proliferation
capacity decrease
Mechanism
Hematopoietic microenviroment defect
stromal cells
hematopoietic growth factor
microcirculation
Mechanism
Immunologic derangement
CD4/CD8(↓,inversion)
γ-IFN, TNFα, IL-2↑
immunosuppressive therapy
Clinical Features
Clinical features:
anemia, infection, hemorrhage
Differences:
AAA(SAA-Ⅰ), CAA , SAA-Ⅱ