Initial Evaluation and Guidelines for Aplastic Anemia

Patient with Pancytopenia

Bone Marrow Biopsy and Aspiration

Cytogenetics

Severe or Very Severe Aplastic Anemia

    Age <40 years                                                                        Age >60 years

  Age<40-50, “good risk”                                                       Age >40 <60. “poor risk”

    Allo BMT                                                        Immunosuppression

Classification of Aplastic Anemia

Severe Aplastic Anemia

    Two of the followings:

1. 1.        Neutrophils < 500 ml
   

2. 2.        Platelets < 20, 000 ml
   

3. 3.        Corrected Reticulocyte Index < 1%
   

    plus Bone Marrow < 25% cellularity

Very Severe Aplastic Anemia

        Neutrophil < 200 ml

“Good Risk” Patients

SWOG Performance Status 0-2

No major c0-morbid condition

Adequate organ function

Transfusion Guidelines

1. 1.Use CMV Negative blood product for patients with Negative CMV serology.
   

2. 2.Use non-family member blood products
   

3. 3.Transfuse PRBC when clinical indicated and not to a pre-set Hemoglobin level.
   

4. 4.Transfuse Platelets if platelet count is < 10 000, or when clinically indicated.