Rare Disease Report

Aplastic Anemia - the Inside Story

OCTOBER 25, 2013
James Radke and Levent Efe

After giving away his last oxygen molecule to a nearby leg muscle, Clyde decided he needed to rest. He was tired. Being a red blood cell was hard work.  Especially lately.  A short break in a small capillary was just what Clyde needed before heading back to the heart and lung for more oxygen.

And the capillary was a nice, quiet place to rest.

Today, it was too quiet.  “Where are all the blood cells?” Clyde wondered.

Normally, the blood vessels were filled with blood cells. Lots and lots of blood cells.  But not lately. The only other blood cell that Clyde could see was Amanda – a white blood cell.

“Hi Amanda, are you taking a break too?” asked Clyde.

Amanda wiped the sweat from her membrane and gave Clyde a weak smile. “Oh, hello Clyde. Yeah, I need to rest for a couple minutes. We are low in white blood cells so I am doing a double shift.

Clyde had a lot of respect for white blood cells.  They cleaned up after cuts, and bruises, and infections. It was a really important job. And a really complicated job. Amanda was probably the smartest cell that Clyde knew.

In contrast, Clyde was a red blood cell and his job was pretty simple. All he had to do was swim around the arteries and hand out oxygen to the body’s muscles and organs. And when he ran out of oxygen, he just swam back to the heart and lungs and get some more.  Swim and hand out oxygen. That is all Clyde had to do. A fun job - under normal circumstances. But lately, there were fewer red blood cells to carry the oxygen and Clyde had to swim faster and faster in order to get oxygen to the rest of the body.

Clyde turned to ask Amanda about the low number of blood cells when he bumped into his good friend, Henry.

“Careful young man,” huffed Henry.

“Sorry, Henry,” said Clyde, adding, “All this extra work is making me clumsy.”  Clyde noticed Henry looked really tired too.  “Are you okay, Henry? You don’t look good.”

Henry smiled weakly and said, “Us older red blood cells can’t give out the oxygen as easily as we used to. Particularly, when we are so low in numbers.” Henry sat down beside Clyde and Amanda, and added, “But, I’ll be fine. Just need to rest for a bit.”With his two friends beside him, Clyde asked, “Where did all the blood cells go?”

Henry answered, “I was up by the ear and overheard the doctor say we might have aplastic anemia.”

Amanda nodded, “That is what I heard too. But they are going to run some more tests first.”

Clyde did not like hearing big medical words. Those words made him nervous.  However, he wanted to act brave in front of his friends so he calmly asked  “What a plastic and mia?”

“Its aplastic anemia,” answered Amanda. “It’s when the body decides to make fewer blood cells.”

Now Clyde was really scared. “What’s going to happen to our body?”

Amanda swam over and gave Clyde a hug.” Don’t worry, we have really good doctors and nurses taking care of us now. They will probably give us some stored blood to help us get our cell numbers back to normal. They call it a blood transfusion.”

“The blood transfusion will give us more blood cells to help us to our job?” asked Clyde.

“Yep,” answered Amanda.

Henry smiled, “Good, we could use some more cells to carry the oxygen.”  Henry looked over at Clyde and thought Clyde needed a good swim to help him stop worrying. “C’mon Clyde.  Let’s head back to the heart and get some more oxygen for the muscles. We still have our jobs to do.”

Clyde nervously smiled.  Maybe a good swim would calm him down.

2 Weeks Later

Swim, swim, swim. Clyde loved to swim. And with the new blood cells that the doctor delivered, Clyde’s work was sooooo much easier. Clyde just swam around handing out oxygen to all the cells and all the cells said ‘Thank you for the oxygen gifts Clyde, you are the best.’  Clyde loved his job. 

Clyde stopped by his favorite resting spot to check up on his two best friends - Henry and Amanda.

“Ain’t life great!” exclaimed Clyde as he arrived at the capillary.

Henry smiled. “Yes it is. With all these extra cells here, my old weary membranes can work at a normal pace. “

Amanda looked up from her clipboard.  “And with the medication we are taking now, I noticed our bodies are starting to make their own blood cells again.  That is really good news.”

Clyde nodded. “Did they ever figure out why we got so low in our blood cells?”

Amanda shook her head. “Nope. The doctor had a few theories but sometimes it just happens. The good news, the medicine is working and our body is healthy again. Now, we have time to do our jobs properly.”

“And have time to rest and talk to friends,” said Henry.

“And swim,” added Clyde.


Story by James Radke. Copyright RDR Communications LLC  www.raredr.com

Image by Levent Efe. Copyright Dr. Levent Efe CMI   www.leventefe.com.au/

About Aplastic Anemia

Aplastic anemia is a rare and potentially serious blood disorder in which the body's bone marrow doesn't make enough red blood cells, white blood cells, and platelets.

In many people who have aplastic anemia, the cause is unknown but may be due to one of a number of causes (eg, toxins, cancer treatment, some medicines, infections, autoimmune disorders, pregnancy).  Treatments for aplastic anemia include blood transfusionsblood and marrow stem cell transplants, and medicines to stimulate bone marrow and to prevent infections. At present, there are no orphan drugs approved for aplastic anemia.

For more information about aplastic anemia, visit http://www.nhlbi.nih.gov/health/health-topics/topics/aplastic/

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