{"doi":"10.1111/bjh.19648","title":"Safety and efficacy of immunosuppressive therapy for elderly patients with severe aplastic anaemia","abstract":"Uncertainty remains regarding the safety and tolerability of immunosuppressive therapy (IST) with anti-thymocyte globulin (ATG) and cyclosporine (CSA) in older patients. We retrospectively analysed two prospective clinical trials of IST in treatment-naïve severe aplastic anaemia (SAA) to assess safety in older compared to younger patients. Patients ≥18 years of age who had received IST with ATG and CSA +/- eltrombopag (EPAG) were included. Pre-treatment baseline characteristics and co-morbidities were assessed as predictors of therapy-related complications in younger (<60 years) versus older (≥60 years) patients. Out of 245 eligible patients, 54 were older and 191 were younger. Older patients had a similar frequency of SAEs, ICU admissions and hospital length of stay compared to younger patients. Older patients had a higher frequency of cardiac events related to IST, but none resulted in death. Older patients had worse long-term overall survival, and more relapse and clonal evolution post-IST. However, older patients who responded to IST had a similar survival at a median follow-up to younger patients. Disease-related factors and limited therapeutic options in refractory disease likely contribute to poorer outcomes in older patients, not complications of upfront IST. Therefore, IST should be considered first-line therapy for most older SAA patients.","journal":"British Journal of Haematology","year":2024,"id":440789,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9614,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":411629,"name":"Jibran Durrani","orcid":"0000-0001-9172-4706","position":1,"is_corresponding":false},{"id":1253243,"name":"Juan Coelho‐Da Silva","orcid":null,"position":2,"is_corresponding":false},{"id":331116,"name":"Ruba Shalhoub","orcid":"0000-0001-7349-6199","position":3,"is_corresponding":false},{"id":265130,"name":"Jennifer Lotter","orcid":null,"position":4,"is_corresponding":false},{"id":417532,"name":"Olga Rios","orcid":"0000-0001-6790-9313","position":5,"is_corresponding":false},{"id":1252745,"name":"David S. Ritchie","orcid":"0000-0001-7329-6605","position":6,"is_corresponding":false},{"id":85436,"name":"Colin O. Wu","orcid":"0000-0002-4514-0926","position":7,"is_corresponding":false},{"id":218228,"name":"Bhavisha A. Patel","orcid":"0000-0002-2974-7701","position":8,"is_corresponding":false},{"id":218269,"name":"Neal S. Young","orcid":"0009-0007-0999-2519","position":9,"is_corresponding":false},{"id":218230,"name":"Emma M. Groarke","orcid":"0000-0002-4648-5926","position":10,"is_corresponding":false},{"id":1252744,"name":"Ashvind Prabahran","orcid":"0000-0003-3135-0401","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-19T02:01:01.842286Z","pmid":"39021060","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}