| Title: |
Updates in acquired aplastic anemia: Can we do more for our patients? |
| Authors: |
Moldovianu, Ana-Maria; Popp, Anca; Varady, Zsofia; Tanase, Alina; Marculescu, Alexandra; Dobrea, Camelia; Vasilache, Didona; Jardan, Cerasela; Niculescu, Radu; Coriu, Daniel |
| Source: |
Documenta Haematologica ; volume 34, issue 1-2, page 1-31 ; ISSN 1582-196X |
| Publisher Information: |
Walter de Gruyter GmbH |
| Publication Year: |
2015 |
| Description: |
The purpose of this work is to present the results of allogeneic stem cell transplantation as therapy for patients diagnosed with acquired aplastic anemia in the Department of Bone Marrow Transplantation of Fundeni Clinical Institute and to elaborate an algorithm of treatment in aplastic anemia starting with the observations obtained from our clinical practice and following the European treatment guidelines in this group of patients. Aplastic Anemia (AA) is a rare hematological disease characterized by pancytopenia and a hypocellular bone marrow. The paradigm of bone marrow failure syndromes, aplastic anemia is a diagnosis of exclusion despite the precision of its diagnosis criteria. Although AA is not a malignant disease, but an autoimmune disorder, the grave consequences of pancytopenia and clonal transformation into acute leukemia make it a potentially fatal condition. The management of AA patients is challenging and necessitates a very well established treatment plan from the diagnosis. We present the treatment algorithm for AA patients with recommendations based on both recent guidelines in the field and on our experience treating AA patients with allogeneic stem cell transplant. Therapeutic procedure algorithm comprises different approaches for different patient populations, age categories and availability of immunosuppression therapy or different types of donors. According to the recent EBMT recommendations the treatment of choice for young patients (younger than 40 years) who have a matched sibling donor is hematopoietic stem cell transplantation (HSCT). For those patients who don’t have a matched sibling donor or are not candidates for HSCT due to older age, the immunosuppression with ATG and cyclosporine is an efficient treatment. The supportive care has an important role and the patients with aplastic anemia should be managed by a multidisciplinary team. For patients older than 40 years, the choice between immunosuppressive therapy (IST) and upfront transplant with HLA identical sibling donor ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1515/dch-2015-0001 |
| Availability: |
https://doi.org/10.1515/dch-2015-0001; http://content.sciendo.com/view/journals/dch/34/1-2/article-p1.xml; https://www.sciendo.com/article/10.1515/dch-2015-0001 |
| Rights: |
http://creativecommons.org/licenses/by-nc-nd/4.0 |
| Accession Number: |
edsbas.21FD9180 |
| Database: |
BASE |