Therapy for aplastic anemia
- PMID: 22160016
- PMCID: PMC4138693
- DOI: 10.1182/asheducation-2011.1.82
Therapy for aplastic anemia
Abstract
A 24-year-old man from Ecuador presents to your clinic with dyspnea on exertion, bruising, and petechiae. He is noted to be pancytopenic with ANC 430, hemoglobin 7.4 g/dL (reticulocyte count 0.9%), and platelets 18 000. His BM biopsy is hypocellular for age. Ultimately, he is diagnosed with severe aplastic anemia. He is the only child of 2 South American parents without any matches in the unrelated donor registry, including cord blood. He is red cell- and platelet transfusion-dependent. He has been recommended therapy with antithymocyte globulin and cyclosporine but declined it. He seeks recommendations about new alternatives to this regimen to improve his chance of response.
References
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- Marsh JC, Ball SE, Cavenagh J, et al. Guidelines for the diagnosis and management of aplastic anaemia. Br J Haematol. 2009;147:43–70. - PubMed
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- Gafter-Gvili A, Ram R, Gurion R, et al. ATG plus cyclosporine reduces all-cause mortality in patients with severe aplastic anemia–systematic review and meta-analysis. Acta Haematol. 2008;120:237–243. - PubMed
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- Tisdale JF, Dunn DE, Geller N, et al. High-dose cyclophosphamide in severe aplastic anaemia: a randomised trial. Lancet. 2000;356:1554–1559. - PubMed
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