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Mark,
Maintaining counts for 4 years is a good record. It's too bad that your dad is no longer getting as good a response.
Is it correct that he has del(5) -- loss of chromosome 5 -- and not del(5q) -- loss of the long arm of chromosome 5?
Other aggressive treatments may not be recommended for an 81-year-old, but you could ask about Dacogen, an alternative to Vidaza that is thought to work similarly. Since you've been at this for years, you probably already know about this.
Supportive care can presumably continue with transfusions. If he'll need platelets regularly, I recommend asking about the methods they can use to lessen the chance that your dad will become refractory to the platelets he receives.
Are his red blood cell and white blood cell counts ok?
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