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

Contact Hematology Fellow, Bone Marrow Failure Team
prior to 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 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
Revised: November 2022
Authors: T. Olson, MD; P. Kurre, MD; J. Oved, MD