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How I treat acquired aplastic anemia.

Abstract
Survival in severe aplastic anemia (SAA) has markedly improved in the past 4 decades because of advances in hematopoietic stem cell transplantation, immunosuppressive biologics and drugs, and supportive care. However, management of SAA patients remains challenging, both acutely in addressing the immediate consequences of pancytopenia and in the long term because of the disease's natural history and the consequences of therapy. Recent insights into pathophysiology have practical implications. We review key aspects of differential diagnosis, considerations in the choice of first- and second-line therapies, and the management of patients after immunosuppression, based on both a critical review of the recent literature and our large personal and research protocol experience of bone marrow failure in the Hematology Branch of the National Heart, Lung, and Blood Institute.
AuthorsPhillip Scheinberg, Neal S Young
JournalBlood (Blood) Vol. 120 Issue 6 Pg. 1185-96 (Aug 09 2012) ISSN: 1528-0020 [Electronic] United States
PMID22517900 (Publication Type: Journal Article, Research Support, N.I.H., Intramural, Review)
Topics
  • Algorithms
  • Anemia, Aplastic (diagnosis, therapy)
  • Bone Marrow Transplantation (adverse effects)
  • Diagnosis, Differential
  • Hematopoietic Stem Cell Transplantation (adverse effects, methods)
  • Humans

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