Aplastic anaemia
Protocols
Clinical Features:
- 1)Fatigue.
- 2)Shortness of breath.
- 3)Rapid or irregular heart rate.
- 4)Pale skin.
- 5)Frequent or prolonged infections.
- 6)Unexplained or easy bruising.
- 7)Nose bleeding and bleeding gums.
- 8)Prolonged bleeding from cuts.
- 9) Petechiae,purpura & ecchymoses
O/E:
- 1)No organo-megaly
- 2)No lymphadenopathy
- 3) pallor
Investigations:
- 1)CBC : Pancytopenia (Hb- low, Leukopenia,Thrombocytopenia)
- Reticulocyte - low
- 2)PBF : Normocytic Anaemia, No abnormal cell
- 3)Bone Marrow :
- Cellularity- hypocellular
- Granulopiesis- reduced
- Erythropiesis- reduced
- Megakaryopiesis- reduced
- 4)Chromosomal study-: exclude Fanconi anaemia
- 5) viral markers - HBsAg
Rx:
- Diet: Neutropenic diet (see below)
- Correction of Anaemia
- Counsel the parents about disease, nature of disease.
Immunomodulation:
- 1)Anti- Thymocyte globulin
- 2)Cyclosporine
- 3)Tacrolimus
Specific Treatment :
- Haemopoietic stem cell transplantation
Prognosis:
- Bone marrow transplantation (HLA- identical sibling) long term survival rate >80%.
Neutropenic diet:
- Dairy: all pasteurized milk and dairy products, such as cheese, yogurt, ice cream, and sour cream.
- Starches: all breads, cooked pastas, chips, French toast, pancakes, cereal, cooked sweet potatoes, beans, corn, peas, whole grains, and fries.