Quote:
Originally Posted by Lisa V
Like most people, I initially thought the 70-80% response rate cited for ATG meant full recovery. I soon found out it doesn't mean that.
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Ha - I thought the SAME thing!
Quote:
Originally Posted by Lisa V
A couple of things I've learned, however, are that a) the human body has a remarkable capacity to adjust itself and compensate for lower than normal counts, and b) that counts can continue to improve for years after ATG treatment. Ken's over 5 years out from his second round, and it's only been in the last 6 months that his Plts have been in the normal range. His WBCs still haven't quite gotten there, but they're getting close. Hgb has been good on its own for the last 3 years or so, but before that he was using Procrit to keep it there. It would be a mistake to look at any set of labs at a given point in time and assume that that's the way it's going to be from now on.
BTW, has anyone come across any statistics for complete remission after ATG? I don't think I've ever seen any figures for that, just "response".
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I agree the body adapts with what it has. So how did Ken feel during all of this?
Quote:
Originally Posted by Hopeful
Different doctors and different reports will use different definitions for responses. This is my favorite for SAA.
A CR is:
* off cyclosporine or equiv
* transfusion independence
* normocellular marrow
* normal counts for age/gender
A PR is:
* transfusion independence
* HGB increased by >3 or platelets increased by >20k (if previously below 20k)
* not CR
Hematological improvement is:
* may still be transfusion dependent but some significant improvement in counts for at least one cell line.
Non-responders have no change or decrease in blood counts.
I'm not sure what your son's initial values were, but if he is now transfusion independent, he has had some kind of response and that is good! It takes time for the marrow to recover. Hopefully, your son's counts will continue their upward trend  |
Hopeful, this is where I get really confused. His initial values were:
wbc 0.7
rbc 9.0
neuts < 500
Platelets 38,000
They did the bone marrow biopsy and it was < 20% cellularity, so they classified him as severe. They did not do ATG for about 5 weeks, and in that time his counts rose to generally:
wbc 2.0
rbc 9.0
neuts 800
platelets 80,000
They did another BMB just before the ATG, and it was "slightly less" than before. His counts are just above those numbers now, but it is too soon for an ATG response. His only transfusion was just before the initial BMB.
So why is he still classified as severe? It seems to be based solely on his BMB.
Lisa, I'm going to the conference Saturday, I will ask your question about complete remissions stats. I'm a math nerd and love statistics.