Eltrombopag & Cyclosporine in Children With Sever Aplastic Anemia

Inclusion Criteria: Current diagnosis of sever Aplastic anemia * Diagnosis of sever Aplastic anemia is established if Bone marrow cellularity \<25% or and at least two of the following criteria are met:- (i) absolute neutrophil count less than 0.5 × 109/L, (ii) platelet count less than 20 × 109/L, and (iii) reticulocyte count less than 20 × 109/L * No, evidence of viral or drug suppression of the marrow, dysplasia, or underproduction anemias secondary to B12, folate, iron or other reversible causes. * Age equal to 1 years old to 18 years old * Written informed consent signed by a parent or legal guardian prior to initiation of any study specific procedure. * Hematopoietic stem cell transplantation is not available or suitable as a treatment option or has been refused by the patient. * Bone marrow aspirate and biopsy at any time during the 4 weeks prior to first dose of eltrombopag Exclusion Criteria: Prior and/or active medical history of:- * Fanconi anemia (via chromosomal breakage test or growth arrest by flow cytometry). Other known underlying congenital/inherited marrow failure syndromes. * Symptomatic Paroxysmal Nocturnal Hemoglobinuria * Other known or suspected underlying primary immunodeficiency * Any malignancy * Active infection not responding to appropriate therapy * Any out of range lab values Creatinine \>2.5 mg/dL× the upper limit of normal, Total bilirubin \>1.5 × the upper limit of normal mg/dL ,Aspartate aminotransferase (AST) or alanine aminotransferase…