Abstract
Background: Aplastic anaemia (AA) is a rare hematologic disorder with substantial morbidity and mortality. Limited data are available on its epidemiology in Central Asia, including Kazakhstan. Objective: To analyze temporal trends and regional variation in the incidence of AA in Kazakhstan from 2014 to 2024. Methods: A retrospective population-based longitudinal study was conducted using national electronic medical records. Incident cases of AA were identified using ICD-10 code D61 and categorized as idiopathic/unspecified or secondary. Incidence rates per 100,000 population were calculated annually and analyzed by region and disease subtype. Descriptive statistics were used to summarize demographic and clinical characteristics. Results: A total of 1,209 incident cases were identified during the study period. The median age was 26 years, with a slight female predominance (52.3%). Most cases were classified as idiopathic or unspecified (88.9%). The national incidence of AA increased from 0.21 per 100,000 population in 2014 to 0.82 per 100,000 in 2024. This increase was primarily driven by idiopathic cases, while secondary AA remained relatively stable and uncommon. Regional variation was observed, with the highest incidence in major urban centers (up to 1.48 per 100,000 in 2024), whereas other regions ranged from 0.3 to 0.9 per 100,000. Conclusion: The incidence of AA in Kazakhstan has increased over the past decade, largely due to a rise in idiopathic cases. Geographic disparities suggest differences in healthcare access and diagnostic capacity. Strengthening surveillance systems and improving equitable access to specialized care are essential for better detection and management of AA.