Aplastic Anemia: Treatment

What are the treatments for aplastic anemia?

The main goal of aplastic anemia treatment is to increase the number of healthy cells in your blood. When your blood counts go up:

  • You are less likely to need blood from a donor (transfusion)
  • Your quality of life gets better
  • Your symptoms are not as bad

Supportive Care

People who have mild or moderate aplastic anemia may not need treatment as long as the condition doesn't get worse. People who have severe aplastic anemia need medical treatment right away to prevent complications.

People who have very severe aplastic anemia need emergency medical care in a hospital. Very severe aplastic anemia can be fatal if it's not treated right away.

Depending on how severe your aplastic anemia is, your doctor will use supportive care to help you manage symptoms and may also treat you with either immunosuppressive therapy or a stem cell transplantation.  Removing a known cause of aplastic anemia, such as exposure to a toxin, also may cure the condition.

There are three categories of treatment for aplastic anemia

Supportive Care

Supportive care is a term used for treatments that help you manage the symptoms of aplastic anemia and is not a cure.  This approach includes the use of:

Immunosuppressive Drug Therapy

Immunosuppressive drug therapy lowers your body's immune response. This prevents your immune system from attacking your bone marrow, lets stem cells grow back, and raises blood counts. In acquired aplastic anemia, immunosuppressive therapy with anti-thymocyte globulin (ATG) plus cyclosporine is the therapy of choice for older patients. It is also used for patients who do not have a matched stem cell donor. About 8 out of 10 patients have a positive response to this treatment.  For patients with severe aplastic anemia (SAA), who have had an insufficient response to immunosuppressive therapy and who are not candidates for stem cell transplant Promacta ® (Eltrombopag) is approved for use. Eltrombopag works by helping to increase production of blood cells.

Stem Cell Transplantation

A stem cell transplant replaces damaged stem cells with healthy ones from another person (a donor).

During the transplant, which is like a blood transfusion, you get donated stem cells through a tube placed in a vein in your chest. Once the stem cells are in your body, they travel to your bone marrow and begin making new blood cells.

Stem cell transplants may cure aplastic anemia in people who can have this type of treatment. The transplant works best in children and young adults with severe aplastic anemia who are in good health and who have matched donors.

Older people may be less able to handle the treatments needed to prepare the body for the transplant. They're also more likely to have complications after the transplant.