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I don't think they ever used cellularity alone to classify aplastic anemia. I think partly because getting good consistent samples from the biopsy is difficult. The BMB is mostly needed to check for abnormal cells and to help diagnose AA vs MDS vs cancer.
To me, this paper is addressing the lack of consistency of diagnosis and treatment that happens when patients are treated by someone with little or no experience with AA. Too many times patients either run into problems that could have been avoided or even died when they are treated in a hospital where they have no experience with ATG/Cylco. On the surface, it sure seems like a pretty simple protocol but as we all know, things can wrong quickly.
And we continue to see doctor using cyclo and steroids as a first line of treatment.
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Marlene, wife to John DX w/SAA April 2002, Stable partial remission; Treated with High Dose Cytoxan, Johns Hopkins, June 2002. Final phlebotomy 11/2016. As of July 2021 HGB 12.0, WBC 4.70/ANC 3.85, Plts 110K.
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