Hi Kmartino07,
So sorry to hear about your diagnosis! I was diagnosed with Aplastic Anemia the first week of december 2013 (I was 21) and by the end of december 2013 my counts were:
WBC: <0.1
Absolute Neutrophils: 0.03 (normal is around 1.60-6.10)
I was getting platelet transfusions (to keep them above 20) and two units of RBCs every two or three days.
Between the options of a BMT or ATG, I opted for ATG. The main reason why is because my doctor explained to me that if ATG doesn't work out for me and my counts are still down afterword, I still have the option of going with a BMT after. However, if I opted straight for a BMT and I faced complications I couldn't rewind and try ATG.
I received ATG in January 2014 and by July 2014 I was transfusion free! My counts were still low, but they became stable to the point transfusions weren't needed. Over the next few months, my counts continued to slow climb towards normal. My last lab was July 17th and my WBC was 4.2, hemoglobin 11.0, and platelets are at 82. I'm still on cyclosporine and hope my platelets keep slowly rising up with time but other then that I'm healthy and happy now!
I remember being in the same position as you debating on BMT or ATG, and the side effects of both were pretty scary! I was lucky enough not to face any serious side effects with my ATG treatment, but recovery still wasn't a total breeze. Much of the time I was in the hospital, and receiving many transfusions (the month after AGT in February I received a total of 14 units of RBC and 9 units of platelets) At times my liver and kidney functions didn't look too good, but my doctor adjusted my cyclosporine dose to keep my organs healthy (especially since BMT was still on the table after my ATG so he wanted to make sure I didn't face any organ issues which would effect my ability to opt for a BMT if necessary).
I'm actually kind of surprised that they're pushing you towards BMT so early, since your counts don't seem to look that bad. I think typically doctors push for treatment when your WBCs are low because you become more susceptible to getting sick and you're body not being able to fight it. But since your WBCs still look relatively good, maybe just get supportive therapy for the time being (i.e.: get transfusions as necessary, and labs done frequently to keep a close eye to make sure things don't get drastically worse) until you're 100% sure of the treatment path you want to go on.
How familiar is your doctor with Aplastic Anemia? If he/she is not, I highly recommend a second opinion since the next step you're going to take is a big one! AAMDS also has a conference coming up in Chicago on Oct 24th with some of the leading experts in AA and BMT, so that's a great place to get information and ask questions and meet with other people who have been in the same situation. If your not well enough to go maybe a family member or close friend can go (I think they also have the lectures online in case you can't). But that's a great source of information. When I was in the hospital, my parents were able to go to two of the conferences and talk to the experts and relay the information they learned to my doctor which helped in determining the next steps in my treatment.
Also- the fact that your counts are holding and not dropping that fast is a good sign! Ideally you want your counts to be going up, but if they're not dropping fast it means your bone marrow is at least producing something. In my case, my bone marrow was making close to nothing so without constant transfusions my counts would drop like crazy (at one point my platelets were at 2 prior to a transfusion
Good luck with everything!!