Hematologist
CION Cancer Clinics
What is aplastic anaemia, and what does it mean for you? | CION Cancer Clinics
Aplastic anaemia means your bone marrow has stopped making enough red cells, white cells and platelets. It is not a cancer, but it is serious, because low counts lead to tiredness, infections and bleeding. It is rare, often caused by the immune system attacking the marrow, and confirmed with a bone marrow test. Treatment calms the immune system or, for some, uses a stem cell transplant. At CION Cancer Clinics, our haematologist cares for anaemia, bleeding, clotting and inherited blood disorders, with ArogyaSri, CGHS and cashless insurance accepted.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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The short answer
What is aplastic anaemia?
Aplastic anaemia means the bone marrow has stopped making enough blood cells. It is not a cancer. The marrow is not full of abnormal cells; it is mostly empty, and all three kinds of blood cell run low at the same time.
What the marrow normally does
Bone marrow is the soft tissue inside your larger bones. It makes red cells, which carry oxygen. It makes white cells, which fight infection. It makes platelets, which help blood to clot. In aplastic anaemia the stem cells that make all three are damaged or attacked, so fewer of each reach the blood.
What that feels like
Low red cells cause tiredness, breathlessness on stairs and a pale look. Low white cells mean infections that keep coming back or take longer to settle. Low platelets show up as easy bruising, tiny red spots on the skin, bleeding gums or nosebleeds that are hard to stop. Some people notice all of these. Others feel almost well and are found only because a routine blood test came back low.
Who gets it
It is rare. It can start at any age, from young children to older adults, and it affects men and women alike. It can come on over a few weeks or build slowly over months.
A low blood count has many causes, most of them common and simple to treat. This page cannot tell you whether your report points to aplastic anaemia. Only a full review, usually including a bone marrow test, can do that.
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What cannot wait
If you or your family member has low counts and develops a fever, shivering, bleeding that will not stop, blood in vomit or stool, or a sudden severe headache, go to the nearest emergency department today or call 108. Tell them the blood counts are low and carry the latest report. Do not wait for the next clinic appointment, and do not take a painkiller at home to bring the fever down first.
Not sure whether this applies to you?
Ask an oncologistWhy it happens
What makes the marrow stop working?
In most adults no single trigger is ever found. Your haematologist will still look carefully, because a few causes change the plan.
The immune system turns on the marrow
This is the most common explanation. Your own immune cells attack the stem cells in the marrow as if they were foreign. Nobody knows exactly why it starts. It is the reason treatment that calms the immune system can help many people.
Medicines, chemicals and radiation
Some medicines and some chemicals can damage the marrow in a small number of people.
Your team will ask about
- Benzene and some solvents at work
- Farm pesticides
- Every medicine taken in recent months
After an infection
Rarely, it follows a viral illness, including some kinds of hepatitis (liver infection). The count may start falling weeks after the illness seemed to have passed.
Inherited marrow failure
A small group, mostly children and young adults, are born with a gene change that makes the marrow fail. Fanconi anaemia is the best known. Spotting it matters, because it changes which treatments are safe.
Brothers and sisters may be tested too.Getting to a diagnosis
How do doctors confirm it?
A full blood count
The first clue is usually a report where haemoglobin, white cells and platelets are all low together. Reference ranges differ between laboratories, and a single result is always read alongside your symptoms and a repeat test.
A blood film and more blood tests
Someone looks at your blood under a microscope. Other tests check vitamin B12, folate, liver function and viral infections, because these can all lower counts and are far more common.
A bone marrow test
A small sample of marrow is taken from the back of the hip bone under local anaesthetic. This is the test that shows whether the marrow is empty rather than crowded with abnormal cells.
Tests to rule out look-alikes
The marrow and blood samples are also checked for PNH, for early marrow cancers and, in younger people, for inherited causes. The result also tells your team how severe the condition is.
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On your report
What do the words on the report mean?
- Hypocellular marrow
- The marrow sample has far fewer blood-making cells than expected, and more fat. This is the typical finding in aplastic anaemia.
- Reticulocytes
- Young red cells just released from the marrow. A low count suggests the marrow is not keeping up.
- Neutrophils
- The white cells that fight bacterial infection. When they are very low, a fever needs same-day care.
- Severe or very severe
- Grades based on how low certain counts are and how empty the marrow looks. The grade guides how quickly treatment starts.
- PNH clone
- A small group of blood cells missing certain surface proteins. It is often found alongside aplastic anaemia and is watched over time.
What comes next
How is aplastic anaemia treated?
Treatment depends on how severe it is, your age, your general health and whether a matched donor is available. Mild cases are sometimes watched with regular blood counts. More severe cases need treatment soon.
Support while the marrow recovers
Red cell and platelet transfusions keep counts at a safer level, and infections are treated quickly. This support buys time. It does not fix the marrow on its own, and your team decides when each transfusion is needed.
Calming the immune system
Many people receive immunosuppressive treatment, often ATG (antithymocyte globulin) with ciclosporin, and sometimes eltrombopag. Improvement is slow and can take months to show. It may not suit people with some other health problems, and it does not help inherited marrow failure.
A stem cell transplant
For some younger patients with a matched brother or sister, a transplant is considered early. It carries serious risks and is not the right choice for everyone.
CION's haematology team reviews your reports, presents the case to a tumour board and coordinates transplant and specialist testing with qualified centres. Ask where each test and treatment will happen. This page cannot tell you your own outlook; your haematologist can.Commonly believed
What do families often get wrong about it?
"Aplastic anaemia is a kind of blood cancer."
It is not. The marrow is empty rather than taken over by cancer cells. It is still serious, and it is often treated by the same haematology teams, which is why families sometimes hear the two spoken about together.
"It is just weakness from poor diet. Iron tonic will fix it."
Iron, tonics and a better diet do not restart a marrow that has stopped. Taking iron without a reason can even cause harm when many transfusions are given. Get the cause confirmed before trying anything at home.
"Regular blood transfusions are the treatment."
Transfusions keep you safe while the real treatment works. They replace cells for a short while but do nothing for the marrow itself. Relying on them alone for months lets the chance of an early, effective plan slip away.
"If there is no donor, nothing can be done."
Many people are treated without a transplant. Immunosuppressive treatment helps a large share of patients, and donor options have widened, including family members who are only half matched. Ask your haematologist which route fits you.
Questions we are asked
Common questions about aplastic anaemia
Is aplastic anaemia the same as leukaemia?
No. In leukaemia the marrow fills with abnormal cells. In aplastic anaemia the marrow is mostly empty. Both can cause low counts, tiredness, infections and bleeding, which is why a bone marrow test is needed to tell them apart. A small number of people with aplastic anaemia develop other marrow conditions later, so follow-up continues for years.
Can it be passed on to my children?
The common form, where the immune system attacks the marrow, is not inherited and cannot spread to anyone. A few inherited types, such as Fanconi anaemia, do run in families. If your team suspects one, they will explain the gene test and whether brothers, sisters or children should be checked.
Is it contagious?
No. You cannot catch it from someone, and you cannot pass it on by touch, food or sharing a room. The person with low counts is the one at risk of catching infections from others, so family members with a cold or fever should keep their distance and wash their hands well.
Can aplastic anaemia go away on its own?
Occasionally a mild case linked to a medicine or infection improves once the trigger is gone. Most moderate and severe cases do not recover without treatment. Waiting and hoping is risky, because very low counts can lead to serious bleeding or infection. Your haematologist will tell you whether watching is reasonable for you.
Which doctor should we see?
A haematologist, a doctor who specialises in blood and bone marrow. A general physician often spots the low counts first and then refers you. Bring every blood report you have, including older ones, because the pattern over time helps the haematologist work out how long the counts have been falling.
What should we eat, and should we avoid anything?
No food restarts the marrow. When white cells are low, eat freshly cooked hot food, drink safe water and avoid raw salads, street food and unpasteurised milk. Do not start herbal remedies or supplements without asking, because some affect blood counts or react with treatment.
Can I work or go to school with it?
It depends on your counts and treatment. Some people keep working with small changes. Others need time off during early treatment, especially when white cells or platelets are very low. Crowded places, contact sports and jobs with injury risk may need to wait. Your team will guide you as your counts change.
Is treatment covered by Aarogyasri or insurance?
Parts of treatment are often covered by Aarogyasri, PM-JAY, CGHS, ECHS, EHS and cashless insurance, but scheme rules change and cover differs by plan. Transplant and long courses of medicine can be handled differently. Call the helpline with your card details and check the current rules before you plan.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- NHS — Aplastic anaemia
- National Heart, Lung, and Blood Institute — Aplastic Anemia
- National Cancer Institute — Definition of aplastic anemia
- American Society of Hematology — Blood disorders: information for patients
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
How Aplastic Anaemia Is DiagnosedThe blood tests and bone marrow test, step by stepSeverity Grading in Aplastic AnaemiaWhat moderate, severe and very severe mean on your reportATG and Immunosuppressive TherapyHow the main non-transplant treatment worksLiving With Aplastic Anaemia During TreatmentFood, infection and daily life while counts are lowAplastic Anaemia and Marrow FailureEvery guide in this section
Talk to us
Holding a report with low counts?
Share it with us or call the helpline. CION's haematology team will review it with you and explain the next step. One helpline serves every CION centre.