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Answer to my original question
Cyclosporine as first line treatment, for anyone looking for treatment options in the Elderly...
Found in Aplastic Anemia: First-line Treatment by Immunosuppression and Sibling Marrow Transplantation by Jakob R. Passweg1 and Judith C.W. Marsh
The decision whether to use ATG in older patients can be difficult and requires careful assessment and discussion of the risks with the patient. For older patients, the response rate and survival rate are lower, compared with younger patients. The response rate for patients aged > 60, 50 to 59, and < 50 years is 37%, 49%, and 57%; 5-year survival is 50%, 57%, and 72%, respectively. For patients aged > 70 years, the 10-year survival is 33%, compared with 60% for those aged between 50 and 70 years.28,29 Although there is no upper age limit for ATG treatment, consideration for treatment should be preceded by medical assessment to exclude significant comorbidities. CSA treatment alone may be considered. The current EBMT treatment algorithm proposes to treat hospitalized patients who are severely ill by ATG + CSA, if considered to be tolerable considering the comorbidity profile, whereas to start newly diagnosed patients who are well and in an outpatient setting with CSA alone.
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Father 72 has been diagnosed VSAA June 2014, was on cyclosporine as first treatment 06/2014 - 09/2014. 8 weeks after diagnosis doctor believe he would not survive ATG Treatment. GCSF 3 weeks Aug 2014 Currently on Eltrombopag 09/14 Danazol 25/08/14.
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