Aplastic anemia is a serious disorder in which bone marrow does not produce enough new, healthy blood cells. In the most severe forms, people experience constant fatigue, shortness of breath, headaches, and heart problems. The condition can be fatal without the proper treatment and ongoing symptom management. Choosing the best aplastic anemia treatment is a collaborative effort between the patient and doctors from many different specialties. Depending on underlying causes and the severity of symptoms, aplastic anemia treatment may involve blood transfusions, bone marrow transplants, immune system-suppressing medications, or a combination of all three.
People who have relatively minor varieties of aplastic anemia in which their blood cell counts are only slightly lower than average may not need any direct treatment. Doctors simply schedule regular appointments so conditions can be monitored closely. Since low white blood cell counts leave people more susceptible to infections and bleeding complications, antibiotics and blood thickening agents may be prescribed.
Moderate anemia is likely to cause noticeable symptoms, such as fatigue, rapid heart rate, and easy bleeding. The most common moderate aplastic anemia treatment measure is periodic blood transfusions. When new blood is given, a medication called cyclosporine is also administered to temporarily reduce the immune system's response and reduce the risk of the body rejecting donor blood. Patients may need to receive several transfusions a year from a matching donor to combat symptoms. Blood transfusions cannot cure aplastic anemia, but they are generally affective at making life manageable while living with the condition.
A severe case of aplastic anemia that does not respond well to blood transfusions may require more aggressive treatment. Healthy bone marrow tissue from a donor can be grafted into a patient's bones to replace dysfunctional tissue. Bone marrow transplants are most effective when the donor is a sibling, but donated tissue from a non-related person with the same blood type still works most of the time. After just a single transplant, most patients are able to recover without ever experiencing recurring anemia. Doctors take extreme precautions during and after transplantation to make sure the patient's body does not reject the grafted material.
Another option for aplastic anemia treatment is a regimen of immunosuppressant drugs. Medical therapy is usually reserved for cases when transfusions fail to relieve symptoms and a suitable donor for bone marrow transplant cannot be found. After performing extensive diagnostic tests, a team of doctors can choose the most appropriate mixture of aplastic anemia treatment medications to give. Cyclosporine limits the production of harmful autoantibodies, and anti-thymocyte globulin, a chemical derived from horses, prevents the immune system from attacking new blood cells. Additional immunosuppressants and drugs to combat infection and inflammation can also be given to provide the best possible chances of recovery.