Abstract
Aplastic anemia (AA) is a hypoproliferative anemia that led to a significant morbidity and mortality. Recently, dramatic improvement in prognosis of AA was achieved; this was in part due to advances in immunosuppressive therapy and HSCT. Nevertheless, AA is still one of the most challenging hematological disorders that could face a hematologist. This study was conducted at Assiut University Hospital (AUH), Assiut, Egypt to evaluate current situation and future prospective of AA. 63 patients with AA were prospectively enrolled in the study; they were admitted at the Hematology unit, AUH in the period 1stJan2011 to Feb2012, a 38 patients with iron deficiency anemia (IDA) were included for comparison. Patients' demographic and clinical data were collected through medical history and clinical examination. Both direct and indirect health care costs of anemia were assessed Direct parameters included doctors' and hospital fees, costs of laboratory investigations, medication fees and costs of HSCT or any procedure. Indirect costs included travelling expenses and earning losses. Social burden of anemia was estimated by anemia related morbidity and mortality. Data were analyzed with SPSSV.17, results showed that AA affected young age group with mean age 30.89±13.39 years, without sex predilection, acquired AA was more common than idiopathic (55.6% vs. 44.4%), however mortality was higher in idiopathic AA (46.2%). Causes of aplasia were exposure to chemicals, drugs and hepatitis in order. Only 63.5% of AA were admitted once and 47.6% in general ward, the mean hospital days for patients with AA was 17.73±11.10, compared to 8.32±6.69 in IDA, P=0.000, also higher socio-economic burden of AA was found compared with IDA. These results denoted that management of AA is still ineffective, and that there is a definite need for a strict plan to prevent incidence of AA, particularly in developing countries where effective management of AA is too expensive and relatively unavailable.
Highlights
Identified as a benign hematological disorder, AA is a devastating disease with consequences and outcomes similar to malignant disorders
AA was found more prevalent in developing than developed countries, and its incidence was linked to low socioeconomic status [3,4,5]
Patients with AA who were admitted at Hematology and BMT unit in the period 1stJan 2011 to Feb 2012 were prospectively enrolled in the study; those with iron deficiency anemia (IDA) who were admitted in the same period were included as a control group
Summary
Identified as a benign hematological disorder, AA is a devastating disease with consequences and outcomes similar to malignant disorders. Clinical course and outcome of acquired AA is similar to that of idiopathic disease, the historical differences between idiopathic and acquired AA is practically not existed [1, 2]. [6,7,8] In Egypt, HSCT is only available for a small proportion of patients; [9] the overall health services provided to patients with AA are very little compared to those in developed countries. This is mainly due to the low socioeconomic status of the country, besides lack of public awareness of AA
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