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Aplastic Anemia Clinical Pathway – All Settings

Clinical Pathway for Evaluation/Treatment of Children
with Suspected Aplastic Anemia

 
 
 
 
Contact Hematology Fellow, Bone Marrow Failure team
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)
 
 
 
 
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
No unrelated
donor available
 
 

Discuss Alternative Therapies

  1. Rabbit ATG Protocol
  2. Haplo stem cell transplant
  3. Eltrombopag

 

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