Aplastic Anemia Patient & Family Handbook

n WHAT IS APLASTIC ANEMIA? Aplastic anemia is a bone marrow failure syndrome. The bone marrow “shuts off” and stops producing white blood cells (WBCs), red blood cells (RBCs), and platelets. As a result, children with aplastic anemia are at risk for life-threatening infections, anemia, and bleeding. Children with aplastic anemia can become very sick and may require prolonged hospitalization, blood and platelet transfusions, intravenous (IV) antibiotics, and other medical tests and treatments. n WHAT IS BONE MARROW? Bone marrow is spongy material located within the bones. It is like the “garden” for the body where the blood-forming cells (WBCs, RBCs, and platelets) grow. These cells are formed from a very young stem cell, which is like a seed. As the seed grows, it blossoms into fully functional and mature WBCs, RBCs, and platelets.

n WHAT DO THE CELLS OF THE BONE MARROW DO?

White Blood Cells WBCs help the body fight infection. They are part of the immune system. Different types of WBCs have different functions. Lymphocytes produce antibodies that allow the body to remember an infection. This memory helps the body to fight and control future exposure to these infections and to respond to immu- nizations. If these cells do not work properly, very serious and life-threatening infections can develop. Neutrophils, which are part of the WBCs, specifically fight bacterial and fungal infections. The absolute neutrophil count (ANC) is a calculated percentage of the WBCs that are neutrophils. This number tells you how well your child’s body is able to fight bacterial infection.

ANC is calculated using the following formula: ANC = total WBCs x (segs/polys + bands)

Multiply total WBCs by the total of segs/polys + bands. (Segs or polys are mature WBCs that fight infec- tion. Bands are immature segs or polys that cannot fight infections as well but do help. The segs/polys and bands are both neutrophils. Different labs may use different terminology to identify neutrophils. Your child’s nurse can show you how to calculate the ANC.) Example: WBC is 5. This means 5,000. Your child has 20% segs (0.20) and 5% bands (0.05). Calculate the ANC as follows: ANC = 5,000 x (.20 + .05) ANC = 5,000 x (.25) ANC = 1,250 A child with a low ANC (less than 1,000) is considered neutropenic or not able to fight infection. A child with an ANC less than 500 is considered severely neutropenic.

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