Aplastic anemia natural history, complications and prognosis: Difference between revisions
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{{Aplastic anemia}} | {{Aplastic anemia}} | ||
'''Editor-In-Chief:''' Aric Hall, M.D., Beth Israel Deaconess Medical Center, Boston, MA [mailto:achall@bidmc.harvard.edu] | |||
==Overview== | ==Overview== | ||
Revision as of 13:57, 21 September 2012
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Editor-In-Chief: Aric Hall, M.D., Beth Israel Deaconess Medical Center, Boston, MA [1]
Overview
Natural History
Untreated aplastic anemia is an illness that leads to rapid death, typically within six months.
Complications
10-33% of all patients develop the rare disease paroxysmal nocturnal hemoglobinuria (PNH, anemia with thrombopenia and/or thrombosis), which has been explained as an escape mechanism by the bone marrow against destruction by the immune system. Flow cytometry testing is probably warranted in all PNH patients with recurrent aplasia.
Prognosis
If the disease is diagnosed correctly and initial treatment is begun promptly, then the survival rate for the next five to ten years is substantially improved, and many patients live well beyond that length of time.
Occasionally, milder cases of the disease resolve on their own. Relapses of previously controlled disease are, however, much more common.
Well-matched bone marrow transplants from siblings have been successful in young, otherwise healthy people, with a long-term survival rate of 80%-90%. Most successful BMT recipients eventually reach a point where they consider themselves cured for all practical purposes, although they need to be compliant with follow-up care permanently.
Older people (who are generally too frail to undergo bone marrow transplants) and people who are unable to find a good bone marrow match have five year survival rate of up to 75%.