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Hi BobbyJD,
Has the trend been established with more than two blood tests? Also, has your sister had any recent illnesses, surgery, or a pregnancy?
If things are trending down, I would ask for another BMB now. This is the only way to know what is really going on. I think the benefit of starting cyclosporine early is that your sister may get away with a lower dosage.
If it were me, I would want the BMB now and then if it showed changes, I would want to start the cyclosporine early (with the option to increase the dosage later) vs at full dosage while in panic-mode later.
Hope things improve for her!
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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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