KINGMAN - Kathy Zach knew nothing about aplastic anemia in October 2005, when her son Paul II (now 28) was diagnosed with the disorder that hinders bone marrow from producing red and white blood cells and platelets.
"Paul was tired all the time, but we thought it was due to him working long hours," Kathy Zach said.
"He also had small red spots on the back of his legs and his gums had been bleeding.
"But it was not until he made a trip to Alabama that we found out he had aplastic anemia. He fell and got a big bruise on one leg, and a dog scratched his arm.
"He went to the emergency room at Huntsville Hospital and was diagnosed through blood testing. The average person has 150,000-200,000 platelets in their body every day, and Paul had only 5,000, so he was within days of dying."
Zach, her husband, Paul I, and younger son, Brian (now 24), had to read whatever material they could find on aplastic anemia.
One good source is the Dana Farber Cancer Institute in Boston.
The Web site states aplastic anemia occurs when the bone marrow produces too few blood cells and platelets. A reduction in RBC causes hemoglobin (a type of protein that carries oxygen to tissues) to fall. A drop in WBC count leaves the patient susceptible to infections. Fewer platelets means blood does not clot in normal fashion and even a scratch could allow the patient to bleed to death.
Paul Zach II, who is a construction superintendent, did not wish to speak about his blood disorder. But he agreed to let his mother do so to raise awareness of the importance of blood donations. Zach has an "idiopathic" type of the disorder, meaning its cause in his case is unknown. Some known causes include viruses, high doses of radiation and exposure to benzene, which is used as a racing fuel, Kathy Zach said.
Zach entered May Clinic in Scottsdale on Nov. 1, 2005. He was in and out of the medical facility through March 2006.
Kathy Zach said her son initially received a serum developed from horse blood twice a day for 14 days. It kills T cells so they don't attack the bone marrow.
In November 2005, Zach underwent numerous transfusions of blood and platelets. High doses of steroids were added to the treatment plan to help his body begin producing bone marrow, she said. In early February 2006, it appeared Zach would need a bone marrow transplant. Testing of chromosomes and checks of ethnic backgrounds ruled out any member of his immediate family as a potential donor.
Zach underwent two weeks of chemotherapy to bring his immune system down to zero in preparation and a single exact match was found.
"In mid-February, Paul's body began producing some red cells and platelets," Kathy Zach said. "His blood was tested daily and during that time he was sustained with red cells and platelets from donors, plus medications."
Zach's white blood cell count took longer to rebound. He wore a mask whenever he was outside Mayo Clinic.
He contracted a fungus infection in his sinus cavity and chest and had to undergo high doses of antibiotics to fight that problem over a three-month period that included a full month in the hospital, she said.
"After the fungus infection cleared up, it was February (2006) and Paul's platelet count began going up," Kathy Zach said. "His doctor said we should hold off on the marrow transplant and the platelet level continued to rise. Paul had a checkup last week and the platelet count was 163,000."
The prognosis is good. Although there is no cure for aplastic anemia, ongoing research and the perfect match found spurs hope if Zach should one day need the bone marrow transplant. "Aplastic anemia causes the immune system to attack bone marrow," she said. "Marrow is the central production center for blood.
"If it wasn't for the donations of blood and platelets needed until he was able to produce his own, Paul would have died."
In addition to fatigue and bleeding gums, common symptoms of aplastic anemia include pale skin, lips and hands, paleness under the eyelids, fever and infections, shortness of breath, nosebleeds and blood in the stool, the Dana Farber Web site states.