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Health A-Z

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Harvard Medical School

Treatment

How you are treated for aplastic anemia depends on its cause and severity. If it is a short-term condition related to medication, pregnancy, low-dose radiation or infectious mononucleosis, then you probably will recover without treatment. However, the symptoms can be treated. For example, bleeding episodes can be treated with transfusions of platelets and red blood cells, while infections can be treated with antibiotics. Women with mild forms of aplastic anemia also may be given oral contraceptives so that their monthly menstrual flow is not excessive.

At home, you will need to use antiseptic soaps, shave with electric razors instead of blades to avoid unnecessary bleeding from nicks, and avoid participating in contact sports. Also, your doctor may prescribe a stool softener to make sure you don't have hard bowel movements, which can make you bleed from your rectum.

The two main treatments for aplastic anemia that is severe and long-lasting are bone marrow transplantation and immunosuppressive therapies.

Most treatments for aplastic anemia require medications that severely impair the normal function of the immune system. This puts patients at risk for infections, often unusual ones. These infections may occur before the bone marrow has had a chance to recover and before the treatments have had their effect. It thus becomes very important to be under the care of specialists in blood disorders and if necessary, specialists in infectious disease.

A bone marrow transplant is the most effective therapy, but the possibility of dying from the treatment increases with age, so it is most ideal for children, adolescents and young adults. In addition, the treatment is safest when the patient has a sibling (brother or sister) with a similar bone marrow type and can be used as a donor. Only about 30 percent of people who need the procedure have siblings who can be donors. In some cases, a donor who is a match but is not related to the patient will be used. However, the rate of complications is higher when the donor is not a sibling.

Some patients will be treated with immunosuppressive medications instead of bone marrow transplantation. These medicines include anti-thymocyte globulin (Thymoglobulin), known as ATG; antilymphocyte globulin (ALG); prednisone (Deltasone, Orasone, Meticorten) and cyclosporine (Neoral, Sandimmune, SangCya). Blood-cell production also can be stimulated with erythropoietin, granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF) or other hematopoietic growth factor medications.

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