Study aid only. Verify against current guidelines, primary literature, staging manuals, and prescribing information before clinical use.

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Aplastic Anemia: Treatment

First-line Second-line SECOND-LINE Severe aplastic anemia (acquired) Young + matched donor Older / no donor Relapsed / refractory Curative Allogeneic HSCT first-line if young, matched sibling IST ATG + cyclosporine + eltrombopag triple immunosuppression ↗ Salvage Alternative-donor HSCT / repeat IST individualized

Aplastic Anemia: overview

This algorithm addresses treatment of acquired severe aplastic anemia, with patient age and donor availability as the first branch point.

Young patients with a matched sibling donor proceed to allogeneic hematopoietic stem cell transplantation as first-line, curative therapy. Older patients, or those without a donor, receive triple immunosuppressive therapy with antithymocyte globulin (ATG), cyclosporine and eltrombopag. For relapsed or refractory disease, salvage is individualized and includes alternative-donor transplantation or a repeat course of immunosuppressive therapy. The key decision is therefore whether a curative transplant from a matched sibling is feasible up front, with immunosuppression serving as the primary first-line strategy for everyone else.

Trials behind this algorithm

Aplastic Anemia: the algorithm in words

Starting point: Severe aplastic anemia (acquired).