Autoimmune-mediated pathogenesis of acquired aplastic anemia: Roles of T lymphocytes

Acquired aplastic anemia (aAA) is a serious life-threatening blood disorder that affects patients of all ages and is characterized by pancytopenia with hypocellular bone marrow (BM). The postulated pathology involves destruction of hematopoietic stem cells by activated T lymphocytes, leading to suppression of BM function. A multitude of etiological factors, genetic predisposition, environmental factors, pregnancy, viral infections, occupational exposure play a predominant role in aAA development. Such factors provoke the immune-mediated attack on progenitor stem cells in the BM. Immunosuppressive therapy and allogeneic BM transplantation are important treatment approaches for aAA. In this paper, we present the knowledge on etiology and research findings on T-cell-mediated immune pathogenesis of aAA, thereby improving the current understanding and providing future research direction.