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

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 Team
No Matched Sibling Donor
Start Immune Suppression Therapy
(Equine ATG Protocol)
No Response
Follow-up after Initiation of ATG
  • Care During the First 12 Months
  • Vaccine Recommendation after Initiation of ATG
  • One Year Evaluation and Wean Of Immune Suppression
  • Long-Term Follow-up
Refer to Bone Marrow Transplant Team for unrelated Donor Search
Donor Available,
Complete BMT
No Unrelated
Donor Available
Discuss Alternative Therapies:
  1. Rabbit ATG Protocol
  2. Haplo Stem Cell Transplant
  3. Eltrombopag
Posted: October 2017
Reviewed: March 2022
Authors: H. Hartung, MD; T. Olson, MD; B. Paul, RN; Kurre, P, MD; Oved, J, MD