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Special issues related to the diagnosis and management of acquired aplastic anemia in countries with restricted resources, a report on behalf of the Eastern Mediterranean blood and marrow transplantation (EMBMT) group and severe aplastic anemia working party of the European Society for blood and marrow transplantation (SAAWP of EBMT)

Bone Marrow Transplantation volume 56, pages 2518–2532 (2021)Cite this article

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A Correction to this article was published on 20 December 2021

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Abstract

Aplastic anemia is a relatively rare but potentially fatal disorder, with a reported higher incidence in developing countries in comparison to the West. There are significant variations in epidemiological as well as etiological factors of bone marrow failure syndromes in the developing countries in comparison to the developed world. Furthermore, the management of bone marrow failure syndromes in resource constraint settings has significant challenges including delayed diagnosis and referral, limited accessibility to healthcare facilities, treatment modalities as well as limitations related to patients who require allogeneic stem cell transplantation. Here we will provide a review of the available evidence related to specific issues of aplastic anemia in the developing countries and we summarize suggested recommendations from the Eastern Mediterranean blood and bone marrow transplantation (EMBMT) group and the severe aplastic anemia working party of the European Society of blood and marrow transplantation (SAAWP of EBMT) related to the diagnosis and therapeutic options in countries with restricted resources.

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Fig. 1
Fig. 2: Proposed treatment algorithm of AA in resource-constrained countries.

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Authors and Affiliations

  1. Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan

    Raheel Iftikhar, Parvez Ahmad & Qamar-Un-Nisa Chaudhry

  2. Saint-Louis Hospital, Paris, France

    Regis de Latour & Regis de Latour

  3. G Gaslini Children Research Hospital, Genova, Italy

    Carlo Dufour

  4. AORN Moscati, Avellino, Italy

    Antonio Risitano

  5. Federico II University, Naples, Italy

    Antonio Risitano

  6. King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

    Naeem Chaudhri, Syed Osman Ahmed, Hazzaa Alzahrani, Ali Alahmari, Walid Rasheed, Riad El Fakih & Mahmoud Aljurf

  7. American University of Beirut Medical Center, Beirut, Lebanon

    Ali Bazarbachi

  8. Imperial College, London, United Kingdom

    Josu De La Fuente

  9. University Hospital Ulm, Ulm, Germany

    Britta Höchsmann

  10. Sidney Kimmel Cancer Center, Philadelphia, PA, USA

    Usama Gergis

  11. National Cancer Institute, Cairo University, Cairo, Egypt

    Alaa Elhaddad

  12. Leiden University Medical Centre, Leiden, The Netherlands

    Constantijn Halkes

  13. King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia

    Bassim Albeirouti

  14. Prince Sultan Military Medical City, Riyadh, Saudi Arabia

    Sultan Alotaibi

  15. King’s College Hospital, London, United Kingdom

    Austin Kulasekararaj, Judith Marsh & Tarek Ben Othman

  16. Center National de Greffe de Moelle Osseuse de Tunis, Tunis, Tunisia

    Tarek Ben Othman

  17. Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

    Simone Cesaro

  18. King Hussein Cancer Center, Amman, Jordan

    Rawad Rihani

  19. Faculty of Medicine, Kuwait University, Jabriya, Kuwait

    Salem Alshemmari

  20. Pediatric Cell Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Amir Ali Hamidieh

  21. University Hospital Establishment, Oran, Algeria

    Mohamed-Amine Bekadja

  22. University Hospital Basel, Basel, Switzerland

    Jakob Passweg

  23. Sultan Qaboos University, Muscat, Oman

    Murtadha Al-Khabori

  24. Universita’ Cattolica del Sacro Cuore, Roma, Italy

    Andrea Bacigalupo

  25. Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden

    Per Ljungman

  26. Division of Hematology Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden

    Per Ljungman

Authors
  1. Raheel Iftikhar
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  2. Parvez Ahmad
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  3. Regis de Latour
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  19. Simone Cesaro
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  22. Salem Alshemmari
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  23. Amir Ali Hamidieh
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  24. Mohamed-Amine Bekadja
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  27. Walid Rasheed
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  28. Andrea Bacigalupo
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  29. Qamar-Un-Nisa Chaudhry
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  30. Per Ljungman
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  31. Judith Marsh
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  32. Riad El Fakih
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  33. Mahmoud Aljurf
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Consortia

on behalf of the Eastern Mediterranean Blood and Marrow Transplantation (EMBMT) Group

  • Raheel Iftikhar
  • , Parvez Ahmad
  • , Naeem Chaudhri
  • , Ali Bazarbachi
  • , Britta Höchsmann
  • , Syed Osman Ahmed
  • , Usama Gergis
  • , Constantijn Halkes
  • , Bassim Albeirouti
  • , Austin Kulasekararaj
  • , Tarek Ben Othman
  • , Simone Cesaro
  • , Ali Alahmari
  • , Rawad Rihani
  • , Salem Alshemmari
  • , Amir Ali Hamidieh
  • , Jakob Passweg
  • , Murtadha Al-Khabori
  • , Andrea Bacigalupo
  • , Judith Marsh
  •  & Mahmoud Aljurf

Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation (SAAWP of EBMT)

  • Regis de Latour
  • , Carlo Dufour
  • , Antonio Risitano
  • , Josu De La Fuente
  • , Alaa Elhaddad
  • , Sultan Alotaibi
  • , Tarek Ben Othman
  • , Mohamed-Amine Bekadja
  • , Walid Rasheed
  • , Qamar-Un-Nisa Chaudhry
  •  & Per Ljungman

Corresponding author

Correspondence to Raheel Iftikhar.

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Conflict of interest

The author declares no competing interests.

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Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Members on behalf of the Eastern Mediterranean Blood and Marrow Transplantation (EMBMT) Group, Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation (SAAWP of EBMT) are listed below.

The original online version of this article was revised: In the original version of this article, the given and family names of Amir Ali Hamidieh were incorrectly structured. The name was displayed correctly in all versions at the time of publication.

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Iftikhar, R., Ahmad, P., de Latour, R. et al. Special issues related to the diagnosis and management of acquired aplastic anemia in countries with restricted resources, a report on behalf of the Eastern Mediterranean blood and marrow transplantation (EMBMT) group and severe aplastic anemia working party of the European Society for blood and marrow transplantation (SAAWP of EBMT). Bone Marrow Transplant 56, 2518–2532 (2021). https://doi.org/10.1038/s41409-021-01332-8

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  • DOI: https://doi.org/10.1038/s41409-021-01332-8

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