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This is a combination therapy consisting of horse anti-thymocyte globulin (hATG), cyclosporine, and eltrombopag. It is primarily used as an immunosuppressive regimen for the treatment of severe aplastic anemia (SAA). - **hATG** is a polyclonal antibody preparation derived from horses immunized with human thymocytes; it depletes T lymphocytes, thereby suppressing immune-mediated destruction of hematopoietic stem cells. - **Cyclosporine** is a calcineurin inhibitor that suppresses T-cell activation by inhibiting interleukin-2 production, further reducing immune attack on bone marrow progenitors. - **Eltrombopag** is an orally bioavailable small-molecule thrombopoietin receptor agonist that stimulates the proliferation and differentiation of megakaryocytes from bone marrow progenitor cells via activation of the JAK/STAT signaling pathway, leading to increased platelet production[1][2][6][8]. Eltrombopag may also have additional effects on other blood cell lineages in aplastic anemia. This triple combination has become standard first-line therapy for newly diagnosed severe aplastic anemia in many settings due to improved response rates compared to immunosuppression alone.
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