Severe Aplastic Anemia (SAA) often results from an abnormal response by the patient's own immune system directed against the bone marrow. As a result, treatment with drugs designed to suppress the immune system may be effective in correcting the blood counts. This treatment most frequently contains a combination of cyclosporine, anti-thymocyte globulin (ATG) and steroids.
With this treatment, 40% of patients will have a complete response and 25% will have a partial response. However, response is slow to occur, usually taking 3-6 months. The SAA may also recur or a pre-leukemia condition may develop months or years later.
The policy of the Leukemia/Bone Marrow Transplant Program in Vancouver is to offer immunosuppressive therapy to all patients of 30 years or older with SAA. It is also offered to younger patients who do not have a matched sibling donor.
Bone Marrow Transplantation (BMT)
A bone marrow transplant (BMT) from a matched sibling donor is a highly effective treatment for SAA. In Vancouver, 70% of such patients have been cured. If SAA patients are aged 55 years or younger and fail to respond to immunosuppressive therapy and do not have a sibling donor, an unrelated donor bone marrow transplant may be considered. The worldwide experience with unrelated-donor bone marrow transplant in SAA is relatively small but it appears that 30% of such patients may be cured with this approach.
The following web sites may provide further helpful information: