INFECTION PREVENTION

Infection prevention

People with severe aplastic anemia are at risk for life-threatening infections. Even a common infection like a cold could become serious. To help prevent infection, people with severe aplastic anemia need to protect themselves from germs. Steps to take may include avoiding crowds and sick people. If you have severe aplastic anemia, talk with your doctor about how you can reduce your risk of infection.

If a fever or other signs of infection appear, the infection must be treated quickly. The most common treatment for infection is antibiotics.

Making treatment choices

If you or your child has severe aplastic anemia, it is important to see a doctor who is an expert in the disease. If your doctor has not treated other patients with aplastic anemia, ask him or her to refer you to an expert for consultation.

A doctor who is an expert in aplastic anemia can talk with you about your treatment options and explain the possible risks and benefits. Whatever treatment you and your doctor decide on, you may choose to be part of a clinical trial. Clinical trials help doctors gain knowledge that can improve treatments for patients in the future. Even standard treatments continue to be studied in clinical trials.

The two standard treatments, immunosuppressive therapy and transplant, have similar long-term survival rates for some groups of patients. Both treatments have potential risks and side effects:
· A transplant has higher risks of life-threatening side effects early after treatment, but a transplant can bring a long-term cure.
· Immunosuppressive therapy has fewer early risks, but most people are not cured and need treatment for the long term.
·Both treatments have some risks of long-term side effects or complications.
· The possible risks and benefits of these treatments vary from one person to another, depending on age and other health factors.

Many doctors recommend a transplant for patients age 20 or younger, especially those who have a suitably matched sibling donor. Doctors also recommend a transplant for many patients between age 20 and 40 who have a suitable sibling donor. For patients older than age 40 and those who do not have a suitable sibling donor, many doctors recommend trying immunosuppressive therapy first. However, age is only one of the factors to look at when making treatment choices. If a patient does not respond to immunosuppressive therapy within three to four months, a transplant using either a sibling or an unrelated donor or cord blood unit may be an option.

The time between diagnosis and transplant can affect transplant outcomes. To improve your chances of a successful transplant, you and your doctor can plan ahead. A consultation with a transplant doctor can help determine whether a transplant is a good option for you, either as the first treatment of choice or as a second treatment if immunosuppressive therapy fails.

Even if you begin treatment with immunosuppressive therapy, your doctor can take steps to be prepared if immunosuppressive therapy does not give you good results. Your doctor can check whether you have any possible donors in your family. He or she can also search the National Marrow Donor Program Registry for potential unrelated volunteer donors or cord blood units. That way, if you and your doctor decide you need a transplant later, the first steps of the donor search will be done and you may be able to move to transplant more quickly.