{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:58:23Z","timestamp":1787979503604,"version":"build-2784847793"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Uncertainty remains regarding the safety and tolerability of immunosuppressive therapy (IST) with anti\u2010thymocyte globulin (ATG) and cyclosporine (CSA) in older patients. We retrospectively analysed two prospective clinical trials of IST in treatment\u2010na\u00efve severe aplastic anaemia (SAA) to assess safety in older compared to younger patients. Patients \u226518\u2009years of age who had received IST with ATG and CSA +\/\u2212 eltrombopag (EPAG) were included. Pre\u2010treatment baseline characteristics and co\u2010morbidities were assessed as predictors of therapy\u2010related complications in younger (&lt;60\u2009years) versus older (\u226560\u2009years) 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\u2010term overall survival, and more relapse and clonal evolution post\u2010IST. However, older patients who responded to IST had a similar survival at a median follow\u2010up to younger patients. Disease\u2010related 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\u2010line therapy for most older SAA patients.<\/jats:p>","DOI":"10.1111\/bjh.19648","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T01:06:21Z","timestamp":1721264781000},"page":"1170-1179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Safety and efficacy of immunosuppressive therapy for elderly patients with severe aplastic anaemia"],"prefix":"10.1111","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3135-0401","authenticated-orcid":false,"given":"Ashvind","family":"Prabahran","sequence":"first","affiliation":[{"name":"National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"},{"name":"Department of Clinical Haematology and Bone Marrow Transplantation Peter MacCallum Cancer Centre\/The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"ACRF Laboratory, The Royal Melbourne Hospital  Parkville Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jibran","family":"Durrani","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Coelho\u2010Da\u00a0Silva","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruba","family":"Shalhoub","sequence":"additional","affiliation":[{"name":"Office of Biostatistics, National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Lotter","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Rios","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7329-6605","authenticated-orcid":false,"given":"David S.","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Department of Clinical Haematology and Bone Marrow Transplantation Peter MacCallum Cancer Centre\/The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"ACRF Laboratory, The Royal Melbourne Hospital  Parkville Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin O.","family":"Wu","sequence":"additional","affiliation":[{"name":"Office of Biostatistics, National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavisha A.","family":"Patel","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal S.","family":"Young","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4648-5926","authenticated-orcid":false,"given":"Emma M.","family":"Groarke","sequence":"additional","affiliation":[{"name":"National Heart, Lung, 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