A 40-year-old woman with severe aplastic anemia has an HLA-matched sibling. She has not received prior transfusions. What is the treatment of choice?

• A Anti-thymocyte globulin and cyclosporine
• B Eltrombopag monotherapy
• C Allogeneic hematopoietic stem cell transplantation ✓
• D High-dose corticosteroids

Explanation

For patients under 40 with severe aplastic anemia and an HLA-matched sibling donor, allogeneic HSCT is the treatment of choice as it offers the best chance of cure and eliminates the risk of clonal evolution to MDS/AML. Prior transfusions increase the risk of graft rejection. Immunosuppression with ATG and cyclosporine is preferred for older patients or those without matched donors.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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