--- title: "A 100-Day Comeback: An 18-Year-Old with Severe Aplastic Anemia Returns to School and Takes the Gaokao" url: "https://www.yyhmedical.com/en/stories/severe-aplastic-anemia-ist-treatment-student-recovery" type: Article inLanguage: en-US disease: Severe Aplastic Anemia treatment: Immunosuppressive Therapy (IST) datePublished: 2026-07-10 --- # A 100-Day Comeback: An 18-Year-Old with Severe Aplastic Anemia Returns to School and Takes the Gaokao > After being diagnosed with severe aplastic anemia during her final year of high school, she received IST, became transfusion-independent within 16 days, achieved a complete hematologic response at three months, and returned to school in time to take the Gaokao. Summary: Xiaoyu (pseudonym) was in her final year of high school, preparing for China's national college entrance examination, when persistent dizziness, fatigue, recurrent infections, and unexplained bleeding spots led to a diagnosis of severe aplastic anemia. Faced with a choice between transplant and non-transplant treatment, the medical team considered her age, disease characteristics, and family circumstances and developed an immunosuppressive therapy (IST) plan using antithymocyte globulin (ATG), cyclosporine, and a thrombopoietin receptor agonist (TPO-RA). Just 16 days after treatment began, she no longer needed blood-product transfusions. Three months later, she achieved a complete hematologic response, returned to school, and went on to complete the Gaokao. In the autumn of 2025, a worried mother hurried into the outpatient corridor of the Anemia Diagnosis and Treatment Center at Beijing GoBroad Boren Hospital. Walking behind her was a thin teenage girl. As a high school senior, she should have been focused on classes and university entrance exams, yet even standing was difficult; after only a few steps, she had to stop and rest. By then, mother and daughter had already been to one hospital after another looking for answers... The story began just as her final year of high school was getting underway. Instead of throwing herself into exam preparation, Xiaoyu began experiencing frequent dizziness and lightheadedness. Climbing stairs caused uncomfortable palpitations. She developed recurrent mouth ulcers, repeated respiratory infections, progressive weight loss, and clusters of unexplained pinpoint bleeding spots on her skin. Alarmed, her mother took her from their local hospital to a major tertiary hospital in Beijing. The blood test showed marked reductions across all three blood cell lines: white blood cells 2.98 x 10^9/L, neutrophils 0.63 x 10^9/L, hemoglobin 67 g/L, and platelets only 20 x 10^9/L. A bone marrow examination ruled out malignancy. The outside hospital initially considered infection-related pancytopenia and treated her with anti-infective therapy and androgen therapy to support blood-cell production. ![15ecee3e-abdb-429a-885a-93c35dbf7b50.png](https://gaobo-byh-h5.oss-accelerate.aliyuncs.com/images/20260913/c5ae8f27758a952da0ab080c5f7cbfb4_20260913162348.png "c5ae8f27758a952da0ab080c5f7cbfb4_20260913162348.png")The patient's first complete blood count at a tertiary hospital in Beijing A month passed, but her symptoms did not improve. Instead, her condition continued to worsen. The downward arrows on each new blood count were frightening for her mother: white blood cells 2.39 x 10^9/L, neutrophils 0.41 x 10^9/L, hemoglobin 63 g/L, and platelets 24 x 10^9/L. A local hospital gave her a red blood cell transfusion, which helped stabilize her temporarily, but everyone knew transfusions alone were not a long-term solution. In October 2025, mother and daughter came to the Anemia Diagnosis and Treatment Center at Beijing GoBroad Boren Hospital. Xiaoyu was so weak that she could barely sit down without her mother's support. Her face showed exhaustion, helplessness, and uncertainty about the future. Her mother had only a few questions in mind: What exactly was wrong with her daughter? Could it be treated? Would she be able to go back to school? We arranged admission immediately and quickly completed a comprehensive bone marrow and hematologic evaluation. The diagnosis was clear: severe aplastic anemia. Severe aplastic anemia is a serious bone marrow failure disorder. It can progress quickly, and without timely and effective treatment, patients may face life-threatening infection or bleeding. For a student like Xiaoyu, it could also put any return to school far out of reach. Because she was so young, we evaluated her particularly carefully and first ruled out inherited bone marrow failure. Genetic testing found no evidence of a congenital cause. Under standard treatment principles, for patients under 40 with severe aplastic anemia who have an HLA-matched sibling donor, allogeneic hematopoietic stem cell transplantation is generally the preferred first-line option. But the family was facing several very real concerns: HLA typing had not yet been completed for her younger siblings. Her parents were deeply worried about transplant-related risks. The possibility of impaired fertility weighed heavily on the family, and treatment costs were another major concern. On top of all this, Xiaoyu was in the most critical year of high school, preparing for the Gaokao. Every concern carried weight, and every decision felt difficult. After repeated discussions and careful consideration, Xiaoyu's mother made a difficult but firm decision to proceed with intensive immunosuppressive therapy (IST). The regimen combined ATG, cyclosporine, and a TPO receptor agonist - a contemporary three-drug non-transplant strategy for severe aplastic anemia. Treatment began. Xiaoyu handled the treatment remarkably well and experienced few significant side effects. Even more encouraging, just 16 days after starting therapy, she became independent of blood-product transfusions. In the hospital, the once-exhausted teenager picked up her textbooks again. She memorized vocabulary between infusions and worked through practice questions whenever she had a quiet moment. The nurses cheered her on: "Keep going - the exam room and your future are waiting for you." After discharge, she continued oral medications to support hematopoietic recovery and returned for weekly monitoring of her blood counts, liver function, and kidney function. Her mother stayed in close contact with the medical team through WeChat, and each change in her blood counts or medication plan was managed through close communication between the family and clinicians. Three months later, spring brought the news everyone had been hoping for. At the three-month IST evaluation, Xiaoyu had achieved a complete hematologic response. Her white blood cell count was 4.29 x 10^9/L, neutrophils 3.29 x 10^9/L, hemoglobin 116 g/L, and platelets 206 x 10^9/L. Her bone marrow function had recovered rapidly. ![be7e94c3-0615-4d66-a8bc-7e3f58ac4aad.png](https://gaobo-byh-h5.oss-accelerate.aliyuncs.com/images/20260913/5b8fd71ed1d86bb03289151354df7e75_20260913164158.png "5b8fd71ed1d86bb03289151354df7e75_20260913164158.png")Complete blood count at the three-month follow-up after intensive IST The girl who had once struggled even to stand was back on her feet. She returned to school and to the goal she had been working toward. Her final-year coursework was demanding, and she had months of material to catch up on, but she kept taking her medication while working steadily through the missed lessons. Few of the students around her knew that only months earlier, she had been hospitalized with a life-threatening bone marrow failure disorder. Then came the day of the Gaokao. She walked calmly into the examination room, just like millions of other students who had spent years working toward this moment, and began writing the next chapter of her future. The wait for the results felt long. Then the good news finally arrived. Her score was well above the undergraduate admission cutoff in her province. ![53de9f40-6808-4765-8c1d-1c9726356439.png](https://gaobo-byh-h5.oss-accelerate.aliyuncs.com/images/20260913/eeb59f0ff63486419c06a384840c95d8_20260913164245.png "eeb59f0ff63486419c06a384840c95d8_20260913164245.png") ![4ff475ca-1683-400b-9f79-f357275434b4.png](https://gaobo-byh-h5.oss-accelerate.aliyuncs.com/images/20260913/f2cfe4db309e9f9c8d4e52f925a90ad2_20260913164310.png "f2cfe4db309e9f9c8d4e52f925a90ad2_20260913164310.png") The patient's exam results (only the total score is shown to protect privacy) The whole family cried with joy. Her mother immediately sent us a screenshot of the result, her messages filled with excitement and gratitude. We still remember something Xiaoyu once told us in the ward: "I want to study education and become a teacher someday." Now that dream is within reach. She is preparing to enter the university she hoped for and move closer to the classroom she has imagined herself standing in so many times. What makes us proudest is not the number on the score report. It is that while recovering from a serious illness and racing against time, she still made it through one of the most demanding years in a Chinese student's education. Looking back, what is a doctor's role? Often, it is simply to do everything possible to keep a patient's unfinished dreams within reach. From diagnosis and treatment decisions, to becoming transfusion-independent in 16 days and reaching a complete hematologic response in three months, from memorizing vocabulary in the hospital to answering questions in the Gaokao examination room - this was more than a medical success. It was a story of determination and courage shared by one young woman, her family, and the people caring for her. Xiaoyu is now preparing for a new chapter. We still have one more goal together: to help her gradually reduce and eventually come off medication when medically appropriate, so she can move into adulthood healthy and free to pursue the life she wants. This summer, we wish her a safe and joyful journey ahead, with many more possibilities waiting to unfold. ![461a617f-f461-4712-8cb2-ff6fff62c979.png](https://gaobo-byh-h5.oss-accelerate.aliyuncs.com/images/20260913/cdfa0d6afd6a86703c0ad0b19c2876a1_20260913164334.png "cdfa0d6afd6a86703c0ad0b19c2876a1_20260913164334.png")The patient presented a banner of thanks to the medical team upon discharge > This content is published with the authorization of the patient and their family, intended solely to share real experiences and health knowledge. It does not constitute a recommendation of any treatment plan or medical diagnostic advice. For specific treatment, please follow the guidance of a professional physician. --- Original (HTML):https://www.yyhmedical.com/en/stories/severe-aplastic-anemia-ist-treatment-student-recovery This is a clean Markdown mirror for large language models; the original page is authoritative.