Conclusion
In summary, we report a case of very severe aplastic anemia in an 80-year old male who had a poor outcome with standard treatment. His adverse risk factors which contributed to his poor disease outcome were probably advanced age, severe pancytopenia at diagnosis, delay in seeking treatment, absence of a minor PNH clone and therapy-related complications. Age on its own should not be a contraindication to treat fit elderly severe AA patients with combination ATG-CsA therapy.