[Leung]

Hi all,

I am new to this forum, but often visit this site. Thanks to all here who shared their knowledge and experience to support each other facing this dreadful disease. I posted in another forum last year about my niece with moderate AA trending towards severe phase. Since Dec last year, my niece needed RBC transfusion every 2 – 3 months, and she had ATG in Aug this year, now on cyclosporine. In the first week post ATG, her Hgb and neutrophil responded quite well, but Hgb then decline. Neutrophil sustained at above 2 initially for 1.5 months but then dropped sharply. Platelet only showed very little improvement. Has now reached the 4-month mark post ATG, still need RBC transfusion, neutrophil around 1.4 (pre-ATG 0.8-1.2) but higher when having fever, platelet between 27 – 37 (pre-ATG 18-27). Just trivial improvement so far. Doctor thought that her AA is likely autoimmune in nature, but such response to ATG is disappointing. Doctor mentioned lightly doing 2nd ATG, but not now, maybe next summer. We asked whether the interval between 1st and 2nd ATG will affect the chance of response in 2nd ATG. Dr. said no particular relation.

Dr. said to wait for 6 months after ATG. So now we can just wait and see whether there will be further improvement. Though I know response to ATG can be as late as 6 to 9 months, is such late response not common? By the time o f 6 to 9 months, there should be no more ATG in the body and the chance of responding is getting lower and lower? I would appreciate any advice/views and sharing, and any experience of slow but continuous improvement after ATG. My niece has no sibling match and has tested not Fanconi. Thanks.