Aplastic anemia medical therapy

Aplastic anemia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Aplastic anemia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Aplastic anemia medical therapy On the Web
Most recent articles
cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Aplastic anemia medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Aplastic anemia medical therapy
CDC on Aplastic anemia medical therapy
Aplastic anemia medical therapy in the news
Blogs on Aplastic anemia medical therapy
Directions to Hospitals Treating Aplastic anemia
Risk calculators and risk factors for Aplastic anemia medical therapy

Editor-In-Chief: Aric Hall, M.D., Beth Israel Deaconess Medical Center, Boston, MA [1]

Overview

Medical therapy of aplastic anemia often includes a short course of anti-thymocyte globulin (ATG or anti-lymphocyte globulin) and several months of treatment with cyclosporin to modulate the immune system. Mild chemotherapy with agents such as cyclophosphamide and vincristine may also be effective. Antibodies therapy, such as ATG, targets T-cells, which are believed to attack the bone marrow. Steroids are generally ineffective.

Supportive Care in treatment of aplastic anemia (DONOT EDIT)

“

Supportive Care Prophylactic platelet transfusions should be given when the platelet count is <10 x 109/L (or <20 x 109/L in the presence of fever). Irradiated blood products should be given routinely to all patients having antithymocyte globulin (ATG) treatment. Transfusion of irradiated granulocyte transfusions may be considered in patients with life-threatening neutropenic sepsis. The routine use of recombinant human erythropoietin (rHuEPO) in aplastic anaemia is not recommended. A short course of granulocyte colony-stimulating factor (G-CSF) may be considered for severe systemic infection that is not responding to intravenous antibiotics and anti-fungal drugs, but should be discontinued after 1 week if there is no increase in the neutrophil count. Prophylactic antibiotic and antifungal drugs should be given to patients with neutrophil count <0.2 x 109/L. Systemic antifungal therapy should be introduced into the febrile neutropenia regimen early if fevers persist. Iron chelation therapy should be considered when the serum ferritin is >1000 µg/L.

”

Definitive treatment of aplastic anemia (DONOT EDIT)

“

Definitive Treatment Specific Treatment of Aplastic Anaemia: General Comments Infection or uncontrolled bleeding should be treated first before giving immunosuppressive therapy. This also applies to patients scheduled for bone marrow transplant (BMT), although it may sometimes be necessary to proceed straight to BMT in the presence of severe infection as a BMT may offer the best chance of early neutrophil recovery. Haemopoietic growth factors, such as rHuEPO or G-CSF, should not be used on their own in newly diagnosed patients in an attempt to 'treat' the aplastic anaemia. Prednisolone should not be used to treat patients with aplastic anaemia because it is ineffective and encourages bacterial and fungal infection.

”