The Person Journey Map

Diamond Blackfan Anaemia (DBA) - The Journey Map

Symptoms

Diamond Blackfan Anaemia (DBA) Symptoms

Common symptoms of DBA include Low haemoglobin, poor feeding, poor sleeping, not growing, fatigue (tiredness), shortness of breath, and headaches.

Blood Tests

It is likely that the first type of test that a GP or consultant will request is a full blood count, including a kidney and liver test. A blood test will show a low blood count across red blood cells, white blood cells, and platelets.

Bone Marrow Biopsy

In DBA, the bone marrow contains fewer red blood cells than normal. The bone marrow sample is examined to rule out other blood-related diseases

Genetic Testing

It will take some time to receive the results from genetic tests, and treatment will most likely begin before the results are available.

Diamond Blackfan Anaemia (DBA) Genetic Testing

Diagnosis

When a person is diagnosed with DBA, a team of expert doctors, nurses and other healthcare professionals are established to oversee the person’s treatment and care.

DBA is a rare blood disease, so careful explanation about its nature and prognosis is required. A person diagnosed with DBA should be given the opportunity to be referred to a hospital that specialises in this rare blood disease. The mental wellbeing of the person diagnosed, and that of their family and close friends is also of great importance.

Treatments may take a long time and may mean reduced contact with family and friends for a while.

Investigation of Immune System

It is likely that you will have to have further blood tests to investigate how your immune system is working. It is advised to have the Chickenpox Vaccine and the Hepatitis B Vaccine.

Transfusions: Minimum 12 Months of age

The purpose of this type of transfusion is to improve a person’s blood count.
Blood transfusions are kept to a minimum of 12 months with the aim to keep the blood level at 100.

Treatment Options

Blood transfusions then a steroid trial and maybe a BMT, whichever treatment option works best for you will be a decision between you and your doctor:

  • Referral to specialist central
  • Regular blood transfusions with chelation
  • Steroids
  • Transplant

Transfusions

  • According to exercise tolerance and growth
  • <250 ml/kg/year

Steroid Treatment

  • Trial of prednisolone 2 mg/kg for four weeks
  • Wean alternate day over 8 weeks 2 mg/kg alternate days typical 1 mg every 6 weeks slow reduction over >6 months prednisolone ?0.5 mg/kg alternate days FerriScan under sedation 5 to 10 years of age: MRI T2*
  • Return to transfusion if no response

2 Years Of Age:

  • FerriScan under sedation
  • Liver biopsy
  • Bone marrow biopsy every five years
  • DEXA scan
  • MRI T2*
  • Monitor film vitamin D

Bone Marrow Transplant From 2 Years Of Age

This may be an appropriate treatment for you.

This requires further discussion with your doctor. Not everyone will be able to have a transplant.

Bone Marrow transplant replaces the bone marrow with friendly marrow as with blood transfusions.

  • Bone marrow biopsy if cytopenia yearly
  • Bone marrow transplant

Health Management & Future Treatment

Diamond Blackfan Anaemia (DBA) Health Management
  • 5 years bone marrow biopsy – yearly FerriScan
  • Regular orthopedic review and endocrine reviews from approx 10 years old
  • Endocrinology review from 10 years of age until the end of pubertal development