The Evolving Landscape of HSCT for Severe Aplastic Anemia

Severe aplastic anemia (SAA) is a life-threatening bone marrow failure disorder characterized by pancytopenia and hypocellular
marrow. Over the past two decades, advances in donor selection, conditioning regimens, supportive care, and graft-versus-host
disease prophylaxis have significantly improved transplant outcomes, leading to renewed consideration of upfront bone marrow
transplantation (BMT) as first-line therapy for selected patients.

This session will review the pathophysiology and clinical presentation of SAA, followed by a discussion of traditional treatment
strategies and their limitations. Emphasis will be placed on the evolving role of upfront BMT, including patient selection, donor sources,
conditioning approaches, and expected outcomes. Current evidence comparing upfront transplantation with immunosuppressive
therapy will be examined, along with emerging data supporting the use of matched unrelated donors. It will conclude with practical, case-based discussions to highlight real-world decision-making, management of
complications, and long-term considerations for patients undergoing upfront BMT.

Presenter: Neel Bhatt, MD, Fred Hutchinson Cancer Center

Moderator: Chelsea Honstain, MS, FNP-C, University of Michigan