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Coping1,
I have a better understanding of your situation now. I can see why your hematologist considers a transplant inevitable, given the strongly likelihood that it's secondary bone marrow failure, after your prior cytoxan therapy. Statistics show that bone marrow failure resulting from previous treatment is less likely to respond to drug treatments. With a well-matched donor, a transplant could give you the best chance of success.
One question this brings up is whether or not you need a confirmed diagnosis. After all, a bone marrow transplant can cure either AA or MDS. But perhaps there are diagnostic differences that are important to know. I think it would be worth asking your doctors about this.
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