What is the best chance for long-term survival in aplastic anemia?

• A. Stem cell therapy
• B. Immunotherapy
• C. Bone marrow transplant
• D. Chemotherapy alone

Answer: (C)

Allogeneic hematopoietic stem cell transplantation (bone marrow transplant) offers the best chance for long-term survival in aplastic anemia because it permanently replaces the defective marrow with healthy donor cells, reconstituting both blood cell production and the immune system. When a patient is younger and has a matched donor (often a sibling), the cure rates after transplant are high and long-term survival is superior to other approaches. Immunosuppressive therapy can control the disease for some time by dampening the immune attack on the marrow, but it does not reliably provide a durable cure and many patients remain transfusion-dependent or experience relapse. Chemotherapy alone doesn’t address the underlying marrow failure and is not curative. Stem cell transplantation, specifically from a matched donor, achieves durable hematopoiesis and immune reconstitution, making it the best option for long-term survival in appropriate patients.