As a benign disease among blood disorders – aplastic anemia has been regarded by many doctors as a disease that is more difficult to treat than leukemia, why? Perhaps because leukemia has a fixed chemotherapy regimen, and as soon as the bone marrow is in remission, normal cells will grow up and symptoms such as anemia, low platelets, and fever will improve, and although most patients are destined to relapse, everything is okay for the patient during the remission period. Aplastic anemia is a different story. If androgens, cyclosporine, ATG and other drugs are ineffective, it seems that there is only one path to bone marrow transplantation, and if the patient is in poor health, pre-treatment is still a problem. So aplastic anemia seems to be a very difficult disease to treat. As a doctor who has been dealing with this disease for a long time, I have always believed that aplastic anemia is not a “disease”, but can be seen as a self-protective response of the human body to some extent. When the stem cells are damaged by the outside world and have the tendency to mutate, the body’s police command “white blood cells” will be alerted and control the stem cells until the stem cells “reform” and can be “released after the sentence”. Therefore, aplastic anemia is not a failure of hematopoiesis, not a lack of seeds. If the bone marrow environment improves and the stem cells repair themselves, it is a natural thing to return to hematopoiesis. This is the case when stem cells from a healthy person are cultured in the plasma of a leukemia patient and hematopoietic suppression occurs. Chronic aplastic anemia has a long buffer period to give doctors sufficient time to correct the situation, and if the stem cells can repair themselves well, the disease will improve, so drugs that damage stem cells should be avoided in treatment. Personally, ATG does not seem to be ideal and does more harm than good. CSA is effective in restoring hematopoiesis, but there is a risk of secondary PNH. Conlivon has been playing an important role as a classic drug for this disease, but attention should be paid to liver function damage. In addition, Chinese herbal medicine has an unexpected role in the treatment of aplastic anemia, and I personally believe that it should be greater than the sum of the above types of drugs. In acute aplastic anemia, the disease progresses rapidly, and infection and bleeding are the main causes of death in this disease. Therefore, it is crucial to fight for the necessary treatment time to reduce death, but under the current medical condition, it is not a problem to fight for 2-3 months of treatment time. Striving to improve the bone marrow environment and promote stem cell repair within those 2-3 months is the key to success, and with that comes a bone marrow transplant for the most part. While I am not a big fan of using bone marrow transplantation, if androgens and CSA combined with herbs can significantly improve hematopoiesis through effective treatment, bone marrow transplantation can be omitted. It is also the best option for the patient.