Aplastic Anemia ww Zhongshan Hospital, Fudan University Zou Shanhua
Aplastic Anemia (AA) Zhongshan Hospital ,Fudan University Zou Shanhua
Outline Bone marrow hematopoiesis failure led by chemicals, radiation, biological factors and unknown etiology. The common clinical presentation is mild to severe pancytopenia
Outline Bone marrow hematopoiesis failure led by chemicals, radiation, biological factors and unknown etiology. The common clinical presentation is mild to severe pancytopenia
Epidemiology The incidence rate of Aa: 74 per1003000, AAA:0.14per1003000 GAA:0.60per100,000 Distribution: most AA patients are young and middle-aged people, male more than female
Epidemiology The incidence rate of AA :0.74 per 100,000， AAA : 0.14 per 100,000, CAA : 0.60 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 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 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
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 stem cell defect Stem cells count decrease Stem cells proliferation capacity decrease
Mechanism Hematopoietic microenviroment defect stromal cells hematopoietic growth factor microcirculation
Mechanism Hematopoietic microenviroment defect stromal cells hematopoietic growth factor microcirculation
Mechanism Immunologic derangement CD4/CD8 (i inversion) YIFN, TNFOL2↑ immunosuppressive therapy
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-Il
Clinical Features Clinical features: anemia, infection, hemorrhage Differences: AAA(SAA-Ⅰ), CAA , SAA-Ⅱ