Severe aplastic anemia: Management challenges at the University Teaching Hospital of Brazzaville

Introduction: Aplastic anemia is a quantitative deficiency of hematopoiesis responsible of pancytopenia with poor bone marrow. This deficiency is often acquired, infectious or iatrogenic. It can also be constitutional and sometimes idiopathic. If the treatment is well codified in developed countries with an improved long-term prognosis for several years, this disease remains highly fatal in developing countries.
Objectives: to highlight the difficulties in the management of severe aplastic anemia at the University Teaching Hospital of Brazzaville.
Methods: It was a historical cohort, carried out on the basis of the records of patients hospitalized for severe aplastic anemia, between January 2000 and December 2014 (15 years). Included patients had at least two Camitta’s criteria.
Results: 30 files were enrolled. In a little over 90% of cases, they were idiopathic aplastic anemia. In 100% of cases the treatment was only symptomatic (red cells and standard plates transfusion, antibiotic therapy), in addition to intravenous Methylprednisolone. The mortality rate was 100% after a median follow-up of 8.3 weeks.
Conclusion: Severe Aplastic anemia remains a dreaded disease at the University Teaching Hospital of Brazzaville. Low socioeconomic status and lack of specific treatment are the two main worsening prognostic factors.