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ATG, like other immunosuppressant treatments, can depress your counts before it improves them, so even if the treatment works you may need transfusions or growth factors to maintain your blood counts until the ATG does its magic. If you don't respond to ATG, counts may be similarly depressed until you "recover" from the ATG.
Of course, without any treatment at all your counts could drop further or start to improve. Such is the unpredictable nature of aplastic anemia.
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