Aplastic anemia can be mild, moderate, or severe.
Mild or moderate aplastic anemia is serious but usually doesn't require hospitalization and may be treated with
- Blood transfusions and/or medications
- Immunosuppressive drugs
- Growth factors.
Severe aplastic anemia, in which blood cell counts are extremely low, is life-threatening, and requires immediate hospitalization for treatment, which is usually a bone marrow transplant. Replacing diseased bone marrow with healthy bone marrow from a donor often successfully cures aplastic anemia.
Having a blood transfusion refers to a patient receiving blood cells from a donor. Transfusions help insure that an anemic patient’s blood cell count stays at a safe level. Platelet transfusions reduce the risk of bleeding problems caused when platelet counts are too low. Red blood cell transfusions reduce symptoms of fatigues.
However, having too many blood transfusions means that iron from red blood cell transfusions can build up in the body and cause organ damage, or, the immune system may develop antibodies that attack the transfused cells.
Because one possible cause of aplastic anemia is the immune system working against itself, one or more immunosuppressive drugs are often given until a stem cell transplant can be performed.
Growth factors are drugs that help the body make more blood cells, which may be given to reduce the number or need for blood transfusions. Given after immunosuppressive therapy or bone marrow transplant, growth factors can help blood cell production or may be used in combination with immune-suppressing drugs to relieve the symptoms of aplastic anemia.
Having aplastic anemia weakens the immune system leaving a person susceptible to all kinds of infections. White blood cells, responsible for fighting off infections, cannot be effectively replaced with a transfusion, so antibiotics are often administered when fever or infection appears.
Bone marrow transplantation
Fred Hutchinson Cancer Research Center physicians pioneered bone marrow transplants for aplastic anemia treatment. If bone marrow or stem cell transplantation is indicated, patients will be seen by Hutchinson Center doctors who are world leaders in stem cell and bone marrow transplantation. When patients have the opportunity to use a matched sibling’s stem cells or bone marrow, there is a 90 percent success rate.
Outcomes are best with matched siblings when patients are under 20 years of age and early after diagnosis, have had minimal prior (irradiated) transfusions, marrow is used as the stem cell source, and CY (cyclosporine) and ATG (methyprednisolone, cyclosporine, and granulocyte colony stimulating factor) are used as conditioning prior to transplant.