When is allogeneic stem cell transplant recommended for aplastic anaemia?

Aplastic anaemia causes the bone marrow to make too few blood cells. A donor transplant aims to replace the failing blood-forming cells with healthy stem cells. Doctors first confirm the diagnosis and assess severity using blood counts, marrow findings, symptoms, transfusion needs, infection history, age, organ function, and donor compatibility. If transplant is not suitable or a donor is not available, medicines that suppress the abnormal immune attack and supportive transfusions may be considered. The choice is individual and may change as the illness or health changes.

Discuss donor testing early because compatibility affects planning. The assessment may include repeated blood tests, marrow examination, infection screening, heart and lung checks, dental review, and fertility counselling. Keep a record of fevers, bleeding, transfusions, and medicines. Avoid crowded settings or unsafe food only according to the team's advice, and contact the haematology service before taking a new medicine or supplement.

Aplastic anaemia can leave too few cells to fight infection or stop bleeding. Seek urgent medical advice for fever, chills, breathlessness, chest pain, fainting, new confusion, heavy bleeding, black stools, or rapidly spreading bruises. After transplant, urgently report fever, a new rash, persistent diarrhoea, jaundice, or reduced urine because infection, graft-versus-host disease, or organ problems may need immediate treatment.

Ask how severe my marrow failure is, whether donor testing should begin now, how transplant compares with immune-suppressing treatment for me, what transfusions or infection precautions I need, and which symptoms require emergency help.