A patient aged 65 years, is diagnosed to have severe aplastic anemia. HLA compatible sibling is available. The best option of treatment is –
**Core Concept**
Severe aplastic anemia (SAA) is a life-threatening condition characterized by bone marrow failure, leading to pancytopenia. In suitable candidates, hematopoietic stem cell transplantation (HSCT) from a matched sibling donor is a potentially curative option.
**Why the Correct Answer is Right**
For patients with SAA, HSCT from a matched sibling donor offers the best chance of cure, with a 70-80% chance of long-term survival. This is because sibling donors share a high degree of human leukocyte antigen (HLA) matching, reducing the risk of graft-versus-host disease (GVHD) and other complications associated with HSCT. The procedure involves replacing the patient's bone marrow with healthy stem cells from the donor, which then repopulates the marrow and restores blood cell production.
**Why Each Wrong Option is Incorrect**
**Option A:** Bone marrow transplantation from an unrelated donor may be considered in the absence of a matched sibling, but it carries a higher risk of GVHD and other complications.
**Option B:** Immunosuppressive therapy, such as antithymocyte globulin (ATG) and cyclosporine, can be used to treat SAA, but it is not curative and may have significant side effects.
**Option C:** Supportive care, including transfusions and antibiotics, can manage symptoms but does not address the underlying bone marrow failure.
**Clinical Pearl / High-Yield Fact**
In patients with SAA, the availability of a matched sibling donor is a critical factor in determining the best treatment option. If a matched sibling is available, HSCT should be considered as soon as possible to maximize the chances of cure.
**Correct Answer:** C.