Posthepatitic Severe Aplastic Anemia—An Indication for Early Bone Marrow Transplantation

Despite the use of androgens, corticosteroids, antibiotics, and blood product support, survival in posthepatitic severe aplastic anemia remains about 10%. Histocompatible bone marrow transplantation in this illness has been shown to be feasible. Therefore, marrow transplantation is indicated early in the course of severe aplasia following hepatitis. Delay of this procedure exposes patients to increasing risks of sepsis, hemorrhage, and sensitization to transplantation antigens by multiple transfusions. Weeks, not months, should elapse between diagnosis and transplantation if an appropriate donor, intensive supportive care, and a trained transplantation team are available.