Quote:
Originally Posted by marmab
When you mention cyclosporine alone, does that mean without ATG first? And is it true that sometimes ATG is tried alone (no cyclosporine afterwards)? Not sure if I have that right.
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The combination of ATG and cyclosporine has a greater success rate than either alone, Marmab. Somebody once explained to me why this is, but I've forgotten the details. They are both immune suppressants, but they apparently act in somewhat different ways and reinforce each other.
There may be times when one or the other will do the trick, however, particularly if the situation is not too severe. Our own experience with cyclo alone at relapse was unsatisfactory, but others have turned it around this way. I don't know as much about using it as a first line treatment for either AA or MDS, but it might be worth a conversation with your doctor.
The only case I can recall hearing of ATG used without cyclosporine (or some other follow-up immune suppressant like Prograf [tacrolimus] or Cellcept [Mycophenolate mofetil]) is this one:
http://www.marrowforums.org/profiles/Andrea_Pecor.html
I don't know why they did it that way, but her first ATG was about 30 years ago, so maybe the protocol hadn't been refined yet?