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Advances in the treatment of aplastic anemia. Over the last 2 decades, there have been changes in the treatment strategy for patients with acquired severe aplastic anemia SAA. Age used to be a significant predictor only in transplantation: it is now also very significant in patients receiving IST.
Two final important messages: a short interval between diagnosis and treatment will improve results, and patients should be entered on well-designed prospective clinical trials in order to attempt to further improve outcomes.
Key words: Severe plastic anemia, anti-thymocyte globulin, hematopoietic stem cell transplantation. Over the last 2 decades, there have been changes in treatment strategy for patients with acquired severe aplastic anemia SAA. This combination is very effective in patients with very severe aplastic anemia vSAA , but less so in patients with non-severe anemia nSAA.
Overall survival has not improved in the last decade for patients given IST. On the other hand, the outcomes of bone marrow transplantation BMT have improved overall, significantly in the last decade. This is mostly true for young patients and for patients receiving an unrelated donor transplant. Age remains a very significant predictor. In some countries patients come to transplant with a heavy transfusion burden, and highly sensitized: the conditioning regimen may need to be modified in this situation, with the addition of low dose total body irradiation TBI or low dose busulfan.
The combination of fludarabine and cyclophosphamide FLU-CY is now being successfully explored instead of the conventional CY regimen in older patients. These results suggest an unrelated donor search should be considered, early in the course of the disease.
Two final important messages: a short interval between diagnosis and treatment will improve results, whatever the first line therapy used: this should call for immediate referral of these rare patients to an experienced center. In addition, because AA is a rare disease, patients should be entered on well-designed prospective clinical trials in order to attempt to further improve outcomes. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License.
Services on Demand Journal. Introduction Over the last 2 decades, there have been changes in treatment strategy for patients with acquired severe aplastic anemia SAA. How to cite this article.
Valentina necesita un trasplante de médula ósea.
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