[AAteen]

Thanks for all your replies. Hope you are all doing well. Dena, good to hear that you only have minor GVHD, which are all manageable. Heather, I have read some of your earlier posts and great to know that your husband is doing well 5 months post transplant. Hope he will continue to do well. Blessings to him. For MUD transplant, GVHD is still a great problem, even with 10/10 match. That’s why we are so reluctant to go for this option before exhausting other options. My niece is too too scared to consider transplant at this stage.

I just managed to get time to listen to the presentations from NIH. Not sure if I get it correctly from Dr Townsley’s presentations. Seems that rabbit ATG (vs horse) is recommended for 2nd round ATG, and stoppage (as opposed to tapering) of cyclosporine at month 6 after ATG is recommended since there is no difference between stoppage and tapering with regard to relapse risk. I recall that there has been an article saying that slow tapering reduces risk of relapse. So, there have been changes in findings in latest studies? Any ideas?

In Dr Townsley’s presentation on “New Directions in Aplastic Anemia Treatment: What’s on the Horizon?”, the results of Promacta in NIH trials sound very encouraging. I have mentioned this drug to our doctor last time, but he seemed not too interested. He said they also use this drug, but for treating other disease and not AA. They will not try Promacta on AA patients at the moment unless there is such clinical trial here or the hospital has participated in such clinical trial organized by other relevant organizations.

Relentless, you have chance to try Promacta, though not have a date yet. If one day you take this drug, I do hope you will achieve excellent results. What are your counts now? Btw, I missed your earlier question regarding the use of steroid after my niece’s 1st ATG. Yes, she was on steroid during and after ATG treatment for about I month. She achieved best counts at different time for different lines. Hgb rose right after ATG, but just for about a week, then decllined and still needed RBC transfusion at month 4 and then hovered between 8+ to 7+ for a year, just above transfusion threshold . ANC fluctuated a lot, responded quite well initially for more than a month, then dropped to slightly better than pre-ATG level, then improved a bit for a few months and then declined back to pre-ATG levels. Platelet is the hardest line with very slow and limited response, best was only 48k at around month 6, but then declined and fluctuated and declined to teens and single digit before re-starting cyclosporine alone last year.