Aplastic Anemia Essay

Decent Essays
The two main treatments for aplastic anemia are immunosuppression (IST) and bone marrow transplantation (BMT).
Immunosuppression with either antithymocyte globulin or cyclosporine is an effective therapy for patients who are not suitable BMT candidates, due to old age or lack of a suitable donor. However, in approximately one third of patients with AA, there is no response to immunosuppression. Immunosuppression can restore the patient’s blood count to normal or near normal for prolonged periods but improvement is not permanent and treatment must be repeated if relapse of AA occurs, and up to 40% of patients eventually relapse. Also, patients who successfully respond to immunosuppressive treatments are still at risk of eventually developing PNH, MDS, or leukemia (associated BMFDs). Considering the rates of relapse and secondary clonal disease following antithymocyte
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The limitations of immunosuppression include the high rates of irresponsiveness and relapse rate after treatment. The creation of an immune biomarker to monitor the disease could allow us to gain a better understanding of the immunological status of an individual AA patient, including disease severity and response to therapy. Also, another consideration to help with IST efficacy is adding growth factors to the treatment, to help aid the signaling.
An advantage of BMT over IST is a marked reduction in both the risk of relapse and the evolution of secondary clonal disorders such as MDS and PNH. BMT is the treatment of choice for young patients who have a human-leukocyte antigen (HLA)-matched sibling donor. However, fewer than 30% of patients will have an HLA-matched sibling donor. So, what if the patient does not have an HLA-matched sibling for BMT? Unfortunately, unrelated donors and mismatched transplants have
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