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Aplastic Anaemia D002

Last amended 
4 April 2016
Current RMA Instruments:
Consolidated RH SOP
50 of 2012 as amended by 31 of 2016
Consolidated BOP SOP
51 of 2012 as amended by 32 of 2016
Changes from previous Instruments:

SOP Bulletin 188

ICD Coding:
  • ICD-9-CM Codes: 284.8, 284.9
  • ICD-10-AM Codes: D61
Brief description

Aplastic anaemia is a blood disorder in which the body's bone marrow doesn't make enough new blood cells. This results in a deficiency of all three types of blood cell: red blood cells (anaemia), white blood cells (leukopaenia), and platelets (thrombocytopaenia).  Collectively this is known as pancytopaenia.

Confirming the diagnosis

Diagnosis requires a bone marrow examination as well as a peripheral blood count. 

Temporary pancytopaenia is a common side effect of treatment for cancer.  Permanent destruction of bone marrow may even be an objective of treatment, ahead of bone marrow transplant.  In either case, where the patient recovers and bone marrow function is restored, a diagnosis of aplastic anaemia will generally not be warranted.

The relevant medical specialist is a haematologist.

Additional diagnoses covered by SOP
  • Red cell aplasia
Conditions not covered by SOP
  • Agranulocytosis – isolated white cell aplasia#
  • Thrombocytopaenia – isolated platelet aplasia#
  • Myelodysplastic syndrome*
  • Leukaemic bone marrow infiltration*
  • Inherited bone marrow failure syndromes#
  • paroxysmal nocturnal haemoglobinuria#

* another SOP applies

# non-SOP condition

Clinical onset

Clinical onset will be based on the laboratory findings.  Once the diagnosis has been confirmed, the clinical picture may allow backdating of onset to a slightly earlier time. 

Clinical worsening

The only worsening factor is for inability to obtain appropriate clinical management.  Aplastic anaemia has a high mortality rate, even with appropriate treatment.