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Hi pvinod,
This is such a difficult decision, but of course no one can make this decision for you. ATG alone used to be the standard of care for AA patients. The success rate was significantly lower than ATG in combination with cyclosporine. I can see your point that she may not have had the full effect of of the combination IST if cyclosporine was at sub-therapeutic levels initially. I do not know how the dosing is done for pediatric patients, so I can't comment on that.
In any case, action is needed now to prevent further progression of the disease. Make sure you talk to the transplant doctor as well, to full understand this option.
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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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