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: June 2022
Authors: H. Hartung, MD; T. Olson, MD; B. Paul, RN; Kurre, P, MD; Oved, J, MD