What are the recommended management strategies for a patient with mild aplastic anaemia in primary care?

Management strategies for a patient with mild aplastic anaemia in primary care focus primarily on supportive care and monitoring, with specialist referral for definitive diagnosis and treatment planning.

In primary care, the key steps include:

• Initial assessment and exclusion of other causes of anaemia: Conduct a thorough clinical evaluation and basic blood tests to exclude other treatable causes of anaemia, as mild aplastic anaemia may present with nonspecific symptoms and cytopenias.
• Referral to haematology: Mild aplastic anaemia requires specialist assessment for confirmation of diagnosis, bone marrow evaluation, and to guide treatment decisions, as primary care management alone is insufficient.
• Supportive care: Monitor blood counts regularly to detect progression or complications such as infections or bleeding.
• Patient education and safety netting: Educate the patient about symptoms that require urgent attention (e.g., bleeding, infections) and ensure timely access to care.
• Avoid unnecessary interventions: Do not initiate treatments such as erythropoietic stimulating agents or iron supplementation unless indicated by specific deficiencies or comorbidities, as aplastic anaemia is a bone marrow failure syndrome rather than a deficiency anaemia.

Overall, primary care's role is to identify possible aplastic anaemia, provide supportive monitoring, and ensure prompt referral to haematology for definitive management.