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Management of Aplasia.
1a Division of Haematology, Department of Cellular and Molecular Sciences , St George's Hospital Medical School , London , UK.
Hematology (Amsterdam, Netherlands)
|July 14, 2016
Summary
Aplastic anemia (AA) survival has improved with treatments like antithymocyte globulin (ATG) and cyclosporine, but careful transfusional support and infection management are crucial due to delayed treatment response.
Area of Science:
- Hematology
- Immunology
Background:
- Aplastic anemia (AA) was historically fatal within months.
- Significant survival improvements have been observed in severe AA over the past two decades.
Purpose of the Study:
- To review current management strategies for aplastic anemia.
- To highlight the importance of supportive care and evolving treatment options.
Main Methods:
- Review of existing literature on aplastic anemia treatment and outcomes.
- Discussion of immunosuppressive therapy (IST), bone marrow transplantation (BMT), and supportive care.
Main Results:
- Antithymocyte globulin (ATG) and cyclosporine offer delayed but effective treatment for AA.
- Transfusional support and infection prophylaxis are critical during treatment delays.
- HLA-identical sibling BMT is established, but unrelated donor transplantation remains high-risk.
- Hematopoietic growth factors have shown limited efficacy, with granulocyte colony-stimulating factor (G-CSF) being a notable exception for infections.
Conclusions:
- While survival has improved, aplastic anemia remains a serious condition requiring comprehensive management.
- Careful transfusional policies and infection control are essential.
- G-CSF may have a role in managing infections in AA patients, particularly post-IST.
