[AAteen]

Relentless, thank you for sharing your experience. I previously learnt from our doctor that the choice of marrow or peripheral blood as a source of stem cell is entirely up to the donor, and they will not attempt to explain or communicate in such a way to influence donor’s decision. Thanks also for sharing Dr Neal Young’s article, which is very informative. Will bring up some issues to discuss with our doctor at our next appointment. Are you going to start Promacta? Any tentative date?

Hopeful. thank you for your advice. We have mentioned 2nd ATG before to our doctor but he did not recommend. He said that as my niece’s response to 1st ATG was not satisfactory, it is unlikely that she will get good response to 2nd ATG. He also said that if 2nd ATG did not work and proceed to BMT then, my niece’s health conditions will then have deterioriated and will affect BMT outcome. Doctor’s concern now is mainly Trisomy 8 as it may signal emerging MDS. My niece resists BMT very much as it sounds too scary to her. Since she does not feel too bad now, except that she needs RBC transfusion every few months, she is not willing to bear the risks of BMT. In fact in 1st ATG, my niece responded quite well initially in RBC and ANC but bounced back and could only maintain slightly above transfusion threshold. Will bring up the option of 2nd ATG again in our next medical appointment

I wonder if trisomy 8 is uncommon in AA patients and the probability of AA with trisomy 8 evolving to MDS/AML? Any insight or information sharing is very appreciated.