Summary of Delphi panel Round 2 expert consensus ratings for subsequent therapy in patients refractory to initial treatment course. (A) Summary plot of recommended subsequent therapy in medically fit patients who are refractory to “triple IST” (horse ATG, CsA, or eltrombopag) based on the best available allogeneic donor option. (B) Summary plot of recommended subsequent therapy in medically fit patients who are refractory to standard IST administered without TPO-RA stratified based on the best available allogeneic donor option. (C) Summary plot of recommended subsequent therapy in medically unfit patients refractory to the initial treatment of CsA eltrombopag (CsA + eltrombopag), or to CsA monotherapy. In all cases, data represent median score ± 95% CI. Scores in the range of 7 to 9 (green color) indicate treatments that would be highly appropriate. Scores in the range of 1 to 3 (red color) indicate testing that would be less appropriate. Intermediate scores in the range of 4 to 6 (white color) may be appropriate under selected circumstances.