Treatment Options

Fanconi Anaemia (FA) is a multifaceted disease and may require treatment from a variety of specialists.

Because FA can affect multiple body systems, care is often best managed by a multidisciplinary team that

works together to coordinate treatment.

Specialist Care for FA

Depending on an individual’s medical issues, different specialists may be involved in care, including:

Specialist support

Blood-related issues - Haematologist

Blood-related issues - Haematologist

Blood-related issues - Haematologist

Digestive issues - Gastroenterologist, Dietician/Nutritionist

Digestive issues - Gastroenterologist, Dietician/Nutritionist

Digestive issues - Gastroenterologist, Dietician/Nutritionist

Ear, nose, and throat problems - Otolaryngologist (ENT)

Ear, nose, and throat problems - Otolaryngologist (ENT)

Ear, nose, and throat problems - Otolaryngologist (ENT)

Whole-body care

Kidney issues - Nephrologist

Kidney issues - Nephrologist

Kidney issues - Nephrologist

Inherited conditions - Geneticist

Inherited conditions - Geneticist

Inherited conditions - Geneticist

Bone abnormalities - Orthopaedist

Bone abnormalities - Orthopaedist

Bone abnormalities - Orthopaedist

Additional support

Mental health - Psychiatrist, Counsellor

Mental health - Psychiatrist, Counsellor

Mental health - Psychiatrist, Counsellor

Female Cancer Screening - Gyneacologist

Female Cancer Screening - Gyneacologist

Female Cancer Screening - Gyneacologist

Other specialists may be consulted as needed based on the patient’s symptoms and complications.

Bone Marrow Failure in FA

How Doctors Diagnose Bone Marrow Failure

Individuals with FA often present with bone marrow failure or squamous cell carcinoma at a very early age.

Diagnosed using:

Initial assessment

Family and medical history - plus a physical examination.

Family and medical history - plus a physical examination.

Family and medical history - plus a physical examination.

Complete blood count (CBC) - checks the number, size, and condition of red blood cells, and counts white blood cells and platelets.

Complete blood count (CBC) - checks the number, size, and condition of red blood cells, and counts white blood cells and platelets.

Complete blood count (CBC) - checks the number, size, and condition of red blood cells, and counts white blood cells and platelets.

Reticulocyte count - measures the number of new red blood cells to determine if the bone marrow is producing them at the proper rate.

Reticulocyte count - measures the number of new red blood cells to determine if the bone marrow is producing them at the proper rate.

Reticulocyte count - measures the number of new red blood cells to determine if the bone marrow is producing them at the proper rate.

Bone marrow tests

Bone marrow tests:

Bone marrow tests:

Bone marrow tests:

Aspiration - a small amount of marrow fluid is removed through a needle.

Aspiration - a small amount of marrow fluid is removed through a needle.

Aspiration - a small amount of marrow fluid is removed through a needle.

Biopsy - a small amount of solid tissue is removed through a needle.

Biopsy - a small amount of solid tissue is removed through a needle.

Biopsy - a small amount of solid tissue is removed through a needle.

Both tests are used to see whether the bone marrow is making enough blood cells.


Why early diagnosis matters:


FA patients often respond poorly to standard chemotherapy and radiation. Knowing a patient has FA before

starting treatment for aplastic anaemia or cancer allows doctors to choose safer, more effective treatment

plans.

OVERVIEW

Bone Marrow Failure

A bone marrow transplant (also called a haematopoietic stem cell transplant) is currently the only cure for

progressive bone marrow failure in FA.

01 · SUPPORTIVE CARE

Medical Management Before a Transplant

Before a transplant is possible, FA patients may need supportive treatments to manage symptoms and stabilise their health, including:

IV (intravenous) transfusions of donated red blood cells and/or platelets

IV (intravenous) transfusions of donated red blood cells and/or platelets

Medicines (such as Neupogen) to increase the number of white blood cells

Medicines (such as Neupogen) to increase the number of white blood cells

Antibiotics to treat or prevent infections

Antibiotics to treat or prevent infections

Androgens (hormones) to increase red blood cells and platelets

Androgens (hormones) to increase red blood cells and platelets

Pain relief medication to improve comfort

Pain relief medication to improve comfort

02 · BONE MARROW

What is Bone Marrow and Why is it Important?

Bone marrow is the spongy tissue found inside your bones. It produces:

Red blood cells (RBC) — carry oxygen around the body; too few causes anaemia, leading to shortness of breath, dizziness, and headaches.

Red blood cells (RBC) — carry oxygen around the body; too few causes anaemia, leading to shortness of breath, dizziness, and headaches.

White blood cells (WBC) — part of the immune system; too few causes neutropenia, increasing infection risk.

White blood cells (WBC) — part of the immune system; too few causes neutropenia, increasing infection risk.

Platelets — help blood clot; too few causes thrombocytopenia, leading to easy bruising, excessive bleeding, and sometimes internal bleeding.

Platelets — help blood clot; too few causes thrombocytopenia, leading to easy bruising, excessive bleeding, and sometimes internal bleeding.

A common symptom of low platelets is petechiae — tiny red spots on the skin caused by bleeding from small vessels under the skin.

A common symptom of low platelets is petechiae — tiny red spots on the skin caused by bleeding from small vessels under the skin.

03 · TRANSPLANT PATHWAY

Overview of a Bone Marrow / Stem Cell Transplant

A bone marrow or stem cell transplant replaces damaged or diseased blood-forming cells with healthy ones

from a matching donor.

Why donor matching matters:

The donor’s cells must match the patient’s cells as closely as possible to reduce the risk of graft-versus-host disease (GVHD), a potential complication where the new immune cells attack the patient’s body.

The Transplant Process:

Find a matched donor (related or unrelated).

Find a matched donor (related or unrelated).

Prepare the patient, usually through chemotherapy.

Prepare the patient, usually through chemotherapy.

Collect donor stem cells in one of two ways:

Collect donor stem cells in one of two ways:

Peripheral stem cells — collected from blood in a process similar to a blood donation (most common method).

Peripheral stem cells — collected from blood in a process similar to a blood donation (most common method).

Bone marrow stem cells — drawn from the hip or sternum under anaesthesia.

Bone marrow stem cells — drawn from the hip or sternum under anaesthesia.

Transfuse healthy donor stem cells into the patient via IV to replace non-functioning stem cells.

Transfuse healthy donor stem cells into the patient via IV to replace non-functioning stem cells.

Engraftment: new stem cells travel to the bone marrow and begin producing healthy blood cells.

Engraftment: new stem cells travel to the bone marrow and begin producing healthy blood cells.

Close monitoring in hospital: typically in an isolation room for 1–2 months to reduce infection risk.

Close monitoring in hospital: typically in an isolation room for 1–2 months to reduce infection risk.

RESOURCES

Further Information & Resources

For more information about stem cell transplants, becoming or finding a donor, and learning about risks, visit:

South Africa Bone Marrow Registry (SABMR)

DKMS Africa

View or Download the BMT Infographic

For more information about blood transfusions, becoming a donor, and understanding the risks, visit: South Africa National Blood Services (SANBS)

Life after a transplant

FA HEALTH RESOURCE

Even after a bone marrow / stem cell transplant cures bone marrow failure, FA patients remain at high risk for certain solid tumors. Regular health check-ups and annual cancer screenings are essential for early detection and prevention.


Download the ‘8 FA Cancer Facts to Remember’ guide in your preferred language.

FREE PATIENT RESOURCE

8 FA Cancer Facts to Remember

Choose a language below to view or download the PDF.

For Patients Diagnosed with Cancer

Individuals with Fanconi Anaemia (FA) have a higher risk of developing certain cancers, especially squamous cell carcinomas. Because of the unique challenges FA presents, conventional treatments like chemotherapy and radiation may cause harmful side effects and are often limited.


Prevention and early detection are key to managing these risks and improving quality of life.


We encourage you to explore our Support page, where you’ll find innovative resources and guidance from leading FA researchers and healthcare experts. These tools are designed to help you navigate the complexities of FA-related cancer risks with confidence and care.

There’s Hope

Gene Therapy in Fanconi Anaemia: An Update

For over 30 years, the Fanconi Cancer Foundation has supported groundbreaking research worldwide to improve treatments and outcomes for people living with Fanconi Anaemia (FA). Thanks to their dedication, promising advances in gene therapy are becoming a reality. Discover the latest breakthroughs and what they could mean for the future of FA care by reading more below.