Aplastic anemia
SEVERE APLASTIC ANEMIA
Definition
Bone marrow cellularity inferior to 30% and at least 2 of the following 3 features:
- Neutrophils < 0.5 X 109/L
- Platelets < 20 x 109/L
- Reticulocytes < 40 000/mm3 (ou < 1% corrected)
Transplantation indications
Related donor transplant
a) Up until age 40:
1st choice if 6/6 HLA identical related donor
b) 41-60 years old:
If patient is refractory to conventional immunosuppressive therapy (treatment must have included ATG and a calcineurin inhibitor)
Unrelated donor transplant
Up until age 60:
If patient is refractory to conventional immunosuppressive therapy (treatment must have included ATG and a calcineurin inhibitor)
Non severe aplastic anemia
Definition
- Neutrophils < 0.5 x 109/L, plt > 20, reticulocytes > 40,000/mm3, OR
- Transfusional support
Transplantation indication
- 18-60 years old with related or unrelated donor and refractory to conventional immunosuppressive therapy (treatment must have included ATG and a calcineurin inhibitor)
