East African Health Research Journal

The basis for better health policy and practice

Survival Outcomes and Treatment Modalities in Aplastic Anaemia Patients: A Six-Year Retrospective Study at Muhimbili National Hospital, Tanzania

  • Gladys Nicholas KaayaDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Department of Clinical Services, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
  • Magdalena LyimoDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  • Clara ChambaDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  • Ahlam Nasser Ahlam NasserDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  • William MawallaDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  • Rebbecca MwakichakoDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  • Michelle MunroeDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  • Johnson MshiuNational Institute for Medical Research, Muhimbili Research Center, Dar es Salaam, Tanzania.
  • Eunice ShijaDepartment of Central Pathology Laboratory Muhimbili National Hospital, Dar es Salaam, Tanzania
  • Koga LuhullaDepartment of Central Pathology Laboratory Muhimbili National Hospital, Dar es Salaam, Tanzania
  • Mwashungi AllyDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Abstract

Background: Aplastic anaemia (AA) is a rare bone marrow failure syndrome characterised by pancytopenia and hypocellular marrow, often resulting from immune-mediated hematopoietic stem cell destruction. Survival data for AA in Tanzania is limited. This study assessed the survival outcomes of AA patients based on available treatment regimens at Muhimbili National Hospital (MNH).
Methods: A retrospective cohort study included all AA patients identified and treated at MNH between January 2018 and December 2023. Clinical and laboratory data, along with socio-demographic information, were extracted from patients’ records. Descriptive statistics of patient characteristics, Kaplan-Meier curves estimated survival outcomes, and the Cox regression model assessed factors associated with mortality risk.
Results: Among 577 patients with pancytopenia, 156 (27%) had acquired idiopathic aplastic anaemia. The median age at diagnosis was 23 years. Majority of the patients had severe AA (49.4%) and very severe AA (36.5%). Treatment regimens included cyclosporine A (59.0%), supportive care alone (21.8%), intensive immunosuppressive therapy (14.1%), and other treatments (4.5%). Only 3 (1.9%) patients underwent allogeneic hematopoietic stem cell transplant abroad. The Kaplan–Meier estimate of overall survival was 27.6%, with a median survival time of 158 days from diagnosis. Supportive care alone and cyclosporine A plus supportive care were associated with higher mortality compared to intensive immunosuppressive therapy.
Conclusion: Patients receiving intensive immunosuppressive therapy demonstrated the most favourable survival outcomes; however, these findings should be interpreted cautiously given the observational design. Expanding access to allogeneic hematopoietic stem cell transplantation and intensive immunosuppressive therapy, alongside early detection and timely referral, is crucial for improving survival of aplastic anaemia patients in Tanzania.

Issue
Vol. 10 No. 2 (2026): East African Health Research Journal
Section
Original Articles
Published
2026-11-04
DOI
https://doi.org/10.24248/eahrj.v10i2.340