Clinical Pathway for Evaluation/Treatment of Children
with Suspected Aplastic Anemia
Contact Hematology Fellow, Bone Marrow Failure team
before obtaining studies
before obtaining studies
- Consider Other Diagnoses
- Inherited bone marrow failure syndromes
- Hemophagocytic lymphohistiocytosis (HLH)
- Moderate aplastic anemia, myelodysplastic syndromes (MDS)/leukemia
Acquired Severe Aplastic Anemia
Available matched sibling donor
Refer to Bone Marrow Transplant Program
No matched sibling donor
Start immune suppression therapy
(Equine ATG Protocol)
(Equine ATG Protocol)
Response
No response
Follow-Up After Initiation of ATG
- Care during the 1st 12 mos
- Vaccine recommendation after initiation of ATG
- 1 yr evaluation and wean of immune suppression
- Long-term follow-up
Refer to Bone Marrow Transplant Program for unrelated donor search
Unrelated
donor available,
complete BMT
donor available,
complete BMT
No unrelated
donor available
donor available
Discuss Alternative Therapies
- Rabbit ATG Protocol
- Haplo stem cell transplant
- Eltrombopag