A 20 yrs adult presents with severe hypoplastic anemia. What is most effective treatment: (LQ)
|C||A TG therapy|
|D||Bone marrow transplantation|
Bone marrow transplantation
Treatment of aplastic anemia (Ref. Hari- 18th ed., Pg. 891)
1. Mild aplastic anemia
a. Antibiotic therapy: Fever of any sign of infection is an indication for empiric broad – spectrum antibiotic therapy.
b. Hematopoietic growth factors like GM – CSF, G – CSF, erythropoietin are given.
i- Supportive care ii- RBC transfusions as necessary iii- Platelet transfusions as necessary
2. Severe aplastic anemia
a. Neutrophil count <500/ml b. Platelet count <20,000/ml c. Reticulocytes <1% iv- BM cellularity <2%
i. Young adults (<50 yrs) who have HLA matched siblings
Treatment of choice is allogenic BM transplantation
ii. Adults (>50 yrs) OR Those without HLA matched sibling
Treatment of choice is immunosuppression with anti thymocyte globuli (ATG) plus cyclosporine