Authors
Avinash Kumar Singh, Ketan Chandra Nathani, Mofizur Rahman Khan, R N Tagore, Mukesh Kumar
Published in
Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion. Volume 42. Issue 6. Pages 2410-2416. Epub Oct 06, 2026.
Abstract
Aplastic anaemia (AA) is a life-threatening bone marrow failure disorder characterized by pancytopenia and hypocellular marrow. Supportive care remains the cornerstone of management, particularly in resource-limited settings and in patients awaiting definitive therapy with immunosuppressive therapy (IST) or haematopoietic stem cell transplantation (HSCT). Effective supportive care optimizes survival, prevents complications, and enhances the success of curative approaches. This chapter outlines evidence-based supportive care strategies tailored for Indian haematology practice. It synthesizes international standards, such as the British Society for Haematology (BSH) Guidelines for the Diagnosis and Management of Aplastic Anaemia (2016 and updated 2024), with national practice paradigms including the recently published Indian Consensus Guidelines for the Diagnosis and Management of Aplastic Anaemia [7] and other Indian clinical experience [4]. This chapter covers transfusion support (red cell and platelet transfusion thresholds, extended red cell phenotyping, leukoreduced and irradiated products, and alloimmunization prevention), infection prophylaxis and management (including multi-drug resistant pathogens and endemic Tuberculosis screening), contemporary therapeutic additions (thrombopoietin-receptor agonists and granulocyte colony-stimulating factor controversies), iron chelation, vaccination protocols, bleeding management, nuanced pregnancy care, patient-led hygiene metrics, and psychosocial support. Practical management algorithms for febrile neutropenia tailored to the Indian antibiogram, cost-optimization strategies leveraging government financial schemes, and seamless integration with curative therapies are also discussed. With the increasing availability of HSCT and antithymocyte globulin (ATG) in India, supportive care must be integrated with definitive therapy to optimize patient outcomes, balancing international evidence with local clinical realities.
PMID:
43021947
Bibliographic data and abstract were imported from PubMed on 13 Nov 2026.
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