Prognosis

The prognosis depends upon the aetiology and severity of the disease:

• pregnancy - 90% mortality
• viral hepatitis - 60% mortality
• thymoma - removal of the tumour may result in complete recovery
• tuberculosis - successful treatment of the infection is associated with complete haematological recovery
• severe aplastic anaemia has a less than 50% chance of survival beyond 6 months

Note - the prognosis of patients with severe or very severe aplastic anaemia has markedly improved over the last 30 years. The 5-year survival with immunosuppressive therapy, using horse anti-thymocyte globulin (ATG) plus ciclosporin, is around 75% to 80%, but lower with rabbit ATG. (2)

Reference

1. Kulasekararaj A, Cavenagh J, Dokal I, et al. Guidelines for the diagnosis and management of adult aplastic anaemia: a British Society for Haematology Guideline. Br J Haematol. 2024 Mar;204(3):784-804.
2. Vaht K, Göransson M, Carlson K, et al. Incidence and outcome of acquired aplastic anemia: real-world data from patients diagnosed in Sweden from 2000-2011. Haematologica. 2017 Oct;102(10):1683-90