Table 2.

High- and low-intensity therapeutic options

High-intensity therapyLow-intensity therapy

  • Horse or rabbit ATG + CsA w/wo eltrombopag

  • Horse or rabbit ATG + other non-CsA immunosuppressant (eg, tacrolimus) w/wo eltrombopag

  • Alemtuzumab

  • Horse or rabbit ATG + CsA + androgens or growth factors

 

  • CsA w/wo eltrombopag

  • Other non-CsA immunosuppressant (eg, tacrolimus)

  • CsA + androgens

  • Androgens (single agent)

  • Growth factors (single agent; eg, erythropoietin or granulocyte colony-stimulating factor)

  • Eltrombopag (single agent)

 
High-intensity therapyLow-intensity therapy

  • Horse or rabbit ATG + CsA w/wo eltrombopag

  • Horse or rabbit ATG + other non-CsA immunosuppressant (eg, tacrolimus) w/wo eltrombopag

  • Alemtuzumab

  • Horse or rabbit ATG + CsA + androgens or growth factors

 

  • CsA w/wo eltrombopag

  • Other non-CsA immunosuppressant (eg, tacrolimus)

  • CsA + androgens

  • Androgens (single agent)

  • Growth factors (single agent; eg, erythropoietin or granulocyte colony-stimulating factor)

  • Eltrombopag (single agent)

 

w/wo, with or without.

These are examples of common therapy combinations. Cyclophosphamide has also shown efficacy for AA but is associated with high levels of toxicity and is no longer routinely recommended.72 

Romiplostim can also be combined with horse or rabbit ATG + CsA or non-CsA immunosuppressant or used as a single agent.

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