New Paper by Dr Neil Young and Dr Phillip Scheinberg
 

Hi everyone, below is a link to a new paper published in the Blood Journal August 9 by Dr's Young and Scheinberg at the NIH.

http://bloodjournal.hematologylibrar...1185.full.html

The paper contains really good current information on AA treatments and strategies from the 2 leading AA experts.

I thought this excerpt, towards the end of the paper & especially the bold text, was particularly interesting because I've seen a lot of postings on Marrowforums where it looks like Dr's have equated success of AA treatment or progress based on celularity of the bone marrow, but this excerpt doesn't seem to necessarily support that theory.

"How we follow SAA long term"
"Responders should be followed for late complications of relapse and clonal evolution (Figure 2). We assess for bone marrow morphology and especially karyotype at 6 and 12 months after treatment and then yearly to monitor for evolution. A hypocellular marrow should not be equated with persistent SAA or relapse in the setting of improving blood counts, as marrow cellularity often does not correlate with blood counts. Blood counts, not marrow cellularity, should guide management."


Best, Dena

How I treat AA.
 

Dena
Thank you for the post. Great information and it answers some questions. I am at 4 months post ATG and am starting to see some increases in HGB and PLT.

Scott:):D

Thank you for finding and posting that article. It was refreshing to see data being proven, not just suggested. It was also nice to read about long term care, I have had difficulty finding information on that subject. I found it uplifting to read that relapse doesn't correlate with lowered survival rate, for that is still a great fear of mine.

Thank you, again.

I find this really interesting: "marrow cellularity often does not correlate with blood counts". I wonder why.

Deb

I don't think they ever used cellularity alone to classify aplastic anemia. I think partly because getting good consistent samples from the biopsy is difficult. The BMB is mostly needed to check for abnormal cells and to help diagnose AA vs MDS vs cancer.

To me, this paper is addressing the lack of consistency of diagnosis and treatment that happens when patients are treated by someone with little or no experience with AA. Too many times patients either run into problems that could have been avoided or even died when they are treated in a hospital where they have no experience with ATG/Cylco. On the surface, it sure seems like a pretty simple protocol but as we all know, things can wrong quickly.

And we continue to see doctor using cyclo and steroids as a first line of treatment.

I agree Marlene. I really liked that the paper was detailed with a lot of conclusive information, and that everything was very clear so readers don't need to have a medical background to understand it.