This is a prospective, single-center, single-arm, phase 2 study. This study aims to evaluate the efficacy and safety of Anti-lymphocyte globulin plus herombopag in combination with moderate-dose cyclophosphamide for severe aplastic anemia.

Inclusion Criteria:

• Male or female age ≥ 12 years
• Subject has a diagnosis of naïve severe or very severe aplastic anemia
• ECOG performance status ≤2
• Unwilling or unable to receive allogeneic hematopoietic stem cell transplantation.
• Willing and able to comply with the requirements for this study and written informed consent.

Exclusion Criteria:

• Previously received immunosuppressive therapy > 4 weeks
• Previously treated with TPO-RA > 4 weeks
• Have an allergy or intolerance to either herombopag or cyclophosphamide.
• Have an allergy to ALG
• Uncontrolled systemic fungal, bacterial, or viral infection
• Poorly controlled hypertension (≥140/90mmHg) or diabetes (a fasting plasma glucose concentration ≥7.0mmol/L or a random venous plasma glucose concentration ≥11.1mmol/L)
• Abnormal liver or kidney function: ALT or AST >3 ULN, or serum creatinine (sCr)≥ 2.5 ULN.
• History of radiotherapy and chemotherapy for malignant solid tumors
• Combined with other serious disorders
• Pregnant or breast-feeding patients
• Patients considered to be ineligible for the study by the investigator for reasons other than the above.