Aplastic anemia in adults

Follow-up for patients with AA is necessary to monitor the need for transfusions and to detect the development of secondary myeloid clonal disorders (paroxysmal nocturnal hemoglobinuria, myelodysplastic syndrome, acute myelogenous leukemia) and lymphoma. The frequency of such follow-up will depend on the severity of the aplasia. Most patients with severe AA will require weekly to biweekly visits for transfusion support. Patients who undergo stem cell transplantation should be followed for transplantation-related complications such as infection, graft versus host disease, and secondary malignancy. Patients who undergo androgen therapy require regular liver monitoring (e.g., liver function, liver computed tomography/ultrasound scan, and alpha fetoprotein).