Canterbury DHB
Allogeneic BMT from a human leucocyte antigen (HLA)-identical sibling donor is the initial treatment of choice for newly diagnosed patients if they have severe or very severe aplastic anaemia, are <40 years old and have an HLA-compatible sibling donor. The recommended source of stem cells for transplantation in aplastic anaemia is bone marrow.
Immunosuppressive therapy is generally recommended for (i) patients with non-severe aplastic anaemia who are transfusion dependent (ii) patients with severe or very severe disease who are >40 years old and (iii) younger patients with severe or very severe disease who do not have an HLA-identical sibling donor.
Matched unrelated donor (MUD) BMT may be considered when a patient has severe aplastic anaemia, has no matched sibling donor but a matched unrelated donor, is <50 years old (or 50–60 years old with good performance status), and has failed at least one course of ATG and ciclosporin.
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Topic Code: 8157