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Secondary aplastic anemia - Treatment

Alternative Names

Anemia - secondary aplastic; Acquired aplastic anemia

Treatment:

It is critical to find out whether secondary aplastic anemia is caused by a medication or exposure. In some cases, removing the exposure can lead to recovery.

Mild cases of aplastic anemia may be treated with supportive care, or may not need treatment. Blood and platelet transfusions will help correct the abnormal blood counts and relieve some symptoms in moderate cases.

Severe aplastic anemia, which causes a very low blood-cell count, is a life-threatening condition. Younger patients with a severe case of the disease will need a bone marrow transplant if a matching donor can be found. Older patients, or those who do not have a matched bone marrow donor, can be treated with medications that suppress the immune system. These medications include anti-thymocyte globulin (ATG), tacrolimus, or cyclosporine.

ATG consists of antibodies made in horses or rabbits against a type of white blood cell in humans called T cells. It is used to suppress the body's immune system. ATG allows the bone marrow to start generating blood cells again, because many causes of aplastic anemia are thought to be due to the body's own T-cells attacking the stem cells.

Other medications to suppress the immune system, such as cyclosporine, tacrolimus, and cyclophosphamide (Cytoxan) also may be used. Corticosteroids and androgens have been used as well.

Expectations (prognosis):

The condition usually gets worse unless the cause is removed or the disease is treated.

Untreated severe aplastic anemia usually gets worse, eventually leading to death. Mild and moderate forms of the disease can be slower.

Bone marrow transplant has been successful in young patients. It has a long-term survival rate of approximately 80%. Older patients have a survival rate of 40 - 70% after a transplant.

Complications:

  • Bleeding in the brain
  • Death caused by bleeding, infections or other complications of a bone marrow transplant, rejection of a bone marrow graft, or severe reactions to ATG
  • Infection

Calling your health care provider:

Call your health care provider if:

  • You have signs of infection, such as fever
  • You bleed for no reason
  • You are feeling extremely tired or short of breath with activity
  • Reviewed last on: 1/31/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Castro-Malaspina H, O'Reilly RJ. Aplastic anemia and related disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 171.

Young NS, Maciejewski JP. Aplastic anemia. In: Hoffman R, Benz EJ, Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 29.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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