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Hi B-OK,
The protocol that I was on recommended starting CsA upon completion of ATG. However, my doctors started both at the same time for me. I think there is greater risk of complications from doing this, as some people can have pretty serious reactions to one or both treatments. Waiting until 2 weeks out may be a more conservative approach but should not have any ill effects in the overall scheme of things. It takes weeks/months before the positive effects of CsA are seen.
I also had an early rise in neutrophil counts and was told that this is a good sign. It took 1.5 months for me to be transfusion free. One thing to also remember is that WBC's may falsely rise if she is on prednisone. So, don't be alarmed if they taper once she is off.
I hope your wife has a good response!
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55 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. small trisomy 6 clone, low-dose cyclosporine dependent
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