Therapy and measures

The therapy of aplastic anaemia is very complex and would go beyond the scope of such an article. The aim of the therapy is to cure aplastic anaemia by fighting the cause. Depending on the cause, it must therefore be planned individually by the treating physician.

It also depends on the age of the patient, the severity of the disease and other factors. A “last resort” is allogenic stem cell transplantation, also known as bone marrow transplantation. However, this very effective option carries many risks, which is why its use must always be individually weighed up by an experienced haematooncologist.

A very important component is also the supportive therapy, by which we mean all medical measures that are carried out to accompany and support the patient. Studies have shown that supportive measures have significantly increased the probability of survival. First and foremost, infection prophylaxis is important here, as even banal infections and actually relatively harmless ones such as mould represent an acute life-threatening threat for patients with aplastic anaemia.

This includes paying attention to special hygiene, i.e. regular hand washing or disinfection, no contact with colds or even so-called reverse isolation in hospital. Preventive use of antibiotics may also be necessary. Furthermore, an “aplastic diet” should be followed, which includes, for example: These measures do not have to be followed by every patient in full aplastic form, the details should always be decided by the attending physician.

Further supportive measures are the transfusion of blood products, the stimulation of the bone marrow and the treatment of side effects by the respective therapy. – consume opened food within 24 hours, otherwise discard

No fresh food that cannot be peeled (especially no salad!) – food that is not industrially packaged, cook well or cook through
No consumption of raw milk products

Life expectancy in aplastic anaemia

Life expectancy depends on several factors. First, aplastic anaemia can be divided into three degrees of severity (moderate, severe, very severe). The classification is based on the number of different blood cells.

The fewer blood cells the bone marrow produces, the more severe the disease is. The number of neutrophil granulocytes, which are white blood cells, and age at diagnosis are the most important prognostic factors. A low number of granulocytes indicates a severe course of the disease with a poor prognosis, since the immune defence of actually harmless pathogens such as fungi (e.g. aspergillus) is then severely impaired.

With a slight severity of the disease, however, life expectancy is hardly limited. In the case of moderately severe and severe courses of the disease, so-called allogenic stem cell transplantation (ASZT) can be carried out as a last measure if the disease cannot be controlled by other measures. This therapy represents a very drastic measure, in which the patient’s bone marrow is destroyed and then replaced by the one donor.

ASCT has many side effects and can be life-threatening in the event of rejection, but the severe form of aplastic anaemia is also often fatal. Supportive measures, i.e. the prevention and treatment of complications, are also very important. The prophylaxis of infections is very important here, but bleeding and anaemia must also be well observed and treated if necessary.