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This can lead to low levels of red blood cells, white blood cells, and platelets, causing anemia, infections, and bleeding problems. ",[68,74,78,82,86],{"key":69,"title":70,"html":71,"icon":72,"updatedAt":73},"","Overview","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Aplastic anemia (AA) is a \u003Cstrong>bone marrow failure disorder\u003C\u002Fstrong>.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Normally, blood-forming stem cells in the bone marrow continuously produce red blood cells, white blood cells, and platelets. In aplastic anemia, these stem cells are greatly reduced in number or function, so the bone marrow cannot produce enough blood cells.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">This can lead to:\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Low red blood cells, causing anemia\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Low neutrophils and other white blood cells, increasing the risk of infection\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Low platelets, increasing the risk of bleeding\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Despite the word “anemia” in its name, aplastic anemia can affect several types of blood cells, not just red blood cells.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Based on blood counts and bone marrow findings, aplastic anemia may be classified as \u003Cstrong>non-severe, severe, or very severe\u003C\u002Fstrong>. This classification plays an important role in treatment decisions.\u003C\u002Fspan>\u003C\u002Fp>","⚕️","2026-10-09",{"key":69,"title":75,"html":76,"icon":77,"updatedAt":73},"Causes and Risk Factors","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Aplastic anemia can occur as an \u003Cstrong>acquired disorder\u003C\u002Fstrong> or as part of an inherited bone marrow failure syndrome. Acquired aplastic anemia is more common.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">In most people with acquired AA, no specific trigger can be identified. The disease is thought to be largely \u003Cstrong>immune-mediated\u003C\u002Fstrong>, with abnormal immune cells—particularly activated T cells—suppressing or damaging blood-forming stem cells.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Some cases may be associated with:\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Certain medications or chemical exposures\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Benzene and other toxic substances\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Certain viral infections or immune responses following infection\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Previous cancer treatment\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Some autoimmune conditions\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Rare pregnancy-associated cases\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 7px 0 7px 72px;text-align: justify;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Inherited bone marrow failure syndromes can sometimes resemble aplastic anemia, and some may not become apparent until adulthood. Genetic evaluation may therefore be needed in younger patients, those with a suggestive family history, or patients with other clinical features.\u003C\u002Fspan>\u003C\u002Fp>","🧬",{"key":69,"title":79,"html":80,"icon":81,"updatedAt":73},"Signs and Symptoms","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Symptoms of aplastic anemia depend mainly on which blood cell types are low and how severe the decrease is.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Some people develop the condition gradually, while others experience a more rapid decline in blood counts.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Low Red Blood Cell Counts\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Anemia may cause:\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Ongoing fatigue or weakness\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Shortness of breath\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Dizziness\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Heart palpitations\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Pale skin\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 7px 0;text-align: justify;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Low White Blood Cell Counts\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Low neutrophil counts in particular may cause:\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Recurrent infections\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Fever\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Mouth or throat infections\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">In severe cases, serious or life-threatening infections\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 7px 0;text-align: justify;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Low Platelet Counts\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Low platelet counts may cause:\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Easy bruising\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Nosebleeds\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Bleeding gums\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Tiny red or purple spots under the skin\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Heavy menstrual bleeding\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">In severe cases, bleeding in internal organs or other sites\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>","📋",{"key":69,"title":83,"html":84,"icon":85,"updatedAt":73},"Diagnosis","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Low blood cell counts alone are not enough to diagnose aplastic anemia because many other conditions can cause pancytopenia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Diagnosis usually involves a \u003Cstrong>complete blood count, reticulocyte count, bone marrow aspiration, and bone marrow biopsy\u003C\u002Fstrong>, along with testing to rule out conditions such as hypoplastic myelodysplastic syndromes, acute leukemia, inherited bone marrow failure syndromes, paroxysmal nocturnal hemoglobinuria (PNH), and other causes of bone marrow failure.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Blood Tests\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">A complete blood count measures red blood cells, white blood cells, and platelets.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">A reticulocyte count shows how effectively the bone marrow is producing new red blood cells. Reticulocyte levels are usually low in aplastic anemia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Additional testing may include liver and kidney function, viral testing, vitamin levels, and other tests to look for alternative causes of low blood cell counts.\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Bone Marrow Tests\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Bone marrow aspiration and biopsy are central to the diagnosis of aplastic anemia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">In typical cases, the bone marrow is markedly hypocellular, with much of the normal blood-forming tissue replaced by fat. The biopsy also helps rule out abnormal tumor cell infiltration, significant fibrosis, and other causes of bone marrow failure.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Testing for PNH\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Some patients with acquired aplastic anemia have a detectable \u003Cstrong>paroxysmal nocturnal hemoglobinuria (PNH) clone\u003C\u002Fstrong>.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Flow cytometry of peripheral blood may be used to test for PNH. This can help with diagnosis and may also provide useful information for ongoing monitoring.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Cytogenetic and Genetic Testing\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Cytogenetic and molecular testing may be performed to help distinguish aplastic anemia from conditions such as MDS.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Younger patients, those with a family history, congenital abnormalities, or other features suggesting an inherited bone marrow failure syndrome may also need germline genetic testing.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\";text-align: justify;\">\u003C\u002Fp>\u003Cp style=\";text-align: justify;\">\u003C\u002Fp>\u003Cp style=\";text-align: justify;\">\u003Cstrong style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp style=\";text-align: justify;\">\u003Cstrong style=\"font-size: 15px;\">Severity Classification\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">The severity of aplastic anemia is assessed using factors such as \u003Cstrong>bone marrow cellularity, absolute neutrophil count, platelet count, and reticulocyte count\u003C\u002Fstrong>.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">The disease is generally classified as:\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cstrong style=\"font-size: 15px;\">Non-severe aplastic anemia (NSAA)\u003C\u002Fstrong>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cstrong style=\"font-size: 15px;\">Severe aplastic anemia (SAA)\u003C\u002Fstrong>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cstrong style=\"font-size: 15px;\">Very severe aplastic anemia (VSAA)\u003C\u002Fstrong>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 7px 0;text-align: justify;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Severe AA is characterized by marked bone marrow hypocellularity together with very low neutrophil, platelet, and\u002For reticulocyte counts. Very severe AA includes even more profound neutropenia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Severity classification directly influences treatment decisions and timing.\u003C\u002Fspan>\u003C\u002Fp>","🩺",{"key":69,"title":87,"html":88,"icon":89,"updatedAt":73},"Treatment","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Treatment for aplastic anemia depends on \u003Cstrong>disease severity, age, overall health, whether the disease is acquired, donor availability, and previous treatment\u003C\u002Fstrong>.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Patients with severe or very severe AA generally need prompt evaluation for \u003Cstrong>allogeneic hematopoietic stem cell transplantation or immunosuppressive therapy\u003C\u002Fstrong>, rather than long-term observation alone.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Monitoring\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Some patients with non-severe disease, stable blood counts, and few or no symptoms may be monitored by a hematologist.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Follow-up generally includes blood counts, reticulocyte counts, and clinical assessment.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Treatment should be reassessed if blood counts worsen, transfusion needs increase, infection or bleeding risks rise, or the disease progresses to severe aplastic anemia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Supportive Care\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Supportive care is important throughout the course of aplastic anemia. \u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">It may include:\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cstrong style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cstrong style=\"font-size: 15px;\">Red blood cell transfusions\u003C\u002Fstrong>\u003Cspan style=\"font-size: 15px;\"> for symptomatic anemia\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cstrong style=\"font-size: 15px;\">Platelet transfusions\u003C\u002Fstrong>\u003Cspan style=\"font-size: 15px;\"> for severe thrombocytopenia or bleeding\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cstrong style=\"font-size: 15px;\">Prevention and treatment of infections\u003C\u002Fstrong>\u003Cspan style=\"font-size: 15px;\"> in patients with severe neutropenia\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cstrong style=\"font-size: 15px;\">Management of iron overload\u003C\u002Fstrong>\u003Cspan style=\"font-size: 15px;\"> in patients who require repeated red blood cell transfusions\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 7px 0;text-align: justify;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">For patients who may undergo transplantation, transfusion strategies are also planned with future transplant needs in mind.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003C\u002Fh3>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Immunosuppressive Therapy\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Because acquired aplastic anemia is usually driven by an abnormal immune attack on blood-forming stem cells, \u003Cstrong>immunosuppressive therapy (IST)\u003C\u002Fstrong> is an important treatment for severe AA.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">A standard approach is based on \u003Cstrong>antithymocyte globulin (ATG) plus cyclosporine\u003C\u002Fstrong>.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">For many patients with severe or very severe acquired AA who are candidates for immunosuppressive therapy, \u003Cstrong>eltrombopag\u003C\u002Fstrong> may also be added to improve blood cell recovery.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">The choice of IST depends on factors such as age, donor availability, disease severity, other health conditions, and treatment options.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003C\u002Fh3>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Hematopoietic-Stimulating Therapy\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Traditional blood cell growth factors are not a substitute for immunosuppressive therapy or transplantation in severe aplastic anemia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Hematopoietic-stimulating treatments may be used in selected situations, and eltrombopag now has a more established role in acquired severe AA, often as part of immunosuppressive therapy or in selected patients based on previous treatment response.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Allogeneic Hematopoietic Stem Cell Transplantation\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important potentially curative treatment for aplastic anemia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">For patients with severe or very severe acquired AA, whether transplantation is used as first-line therapy depends on factors including:\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Age\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Overall health\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Availability of an HLA-compatible donor\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Infections or other complications\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Previous treatment and disease status\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Traditionally, younger patients with an HLA-matched sibling donor are strong candidates for first-line allo-HSCT. As transplant techniques have improved, matched unrelated donor and haploidentical donor transplantation are also becoming options for selected patients.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Transplantation is therefore not simply a “last resort” after medications fail. For some patients with severe AA, donor search and transplant evaluation should begin soon after diagnosis.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Treatment of Infections\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Patients with severe neutropenia have a high risk of infection.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Fever or other signs of infection require prompt evaluation. Antibiotics, antifungal medications, or antiviral medications may be used depending on the type of infection and individual risk.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Preventing and treating infection is a key part of care for severe and very severe aplastic anemia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003C\u002Fh3>\u003Ch3 style=\"margin-top: 7px;margin-bottom: 7px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>Clinical Trials\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Treatment for aplastic anemia continues to evolve, including new immunosuppressive approaches, treatments that promote blood cell production, and transplant strategies using different donor sources and conditioning regimens.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Patients can discuss available clinical trials with their healthcare team based on disease severity, previous treatments, and donor options.\u003C\u002Fspan>\u003C\u002Fp>","💊",{"author":69,"reviewedBy":69,"lastReviewed":69,"datePublished":69,"citations":91,"disclaimer":69},[],false,1792294328254]