[Susan]

Hi all. I was dxed AA/PNH in 1998. My AA went away but probably came back as my ANC is now varying between 200 and 300. BMB tomorrow. Assuming SAA I'll need ATG, risk too high at my age for BMT. I'm in Chicago. Considering these docs, plse give your input, thanks!

1) Local very experienced AA spec good except doesn't do ATG much for some reason.
2) Locally are a couple of very good docs brd cert in Hem, Onc & Internal med who do many BMTs -using ATG and much experience keeping pts alive treating infections, misc side effect care. They've use ATG for MDS and a few SAA cases.

3) Dr Araten at NYU has treated extensively w ATG and has a great rep, bm failure expert. But I'm not thrilled with flying 4 -5 hours home alone with a rash, hives, maybe nausea, zero wbcs and feeling awful side effects/nervous. Plus I doubt very few of his pts have been at such high infection risk as I am.

4) Dr Maciejewski/Cleveland Clinic. He know regimen well, has all bm failure experience, has done a fair amount of ATG. CC closer than NY. But Dr Mac is super busy w/ admin, research, meetings, not sure if could get his personal attn much. Cked all these ctrs overall infection rates and BMT survival outcomes, CC was highest infection, lowest survival.

Right now leaning toward local with Dr Araten reviewing protocol w local Hem/onc. I'll probably go see him first, feel bad calling asking for advise/consult with other doc when haven't seen him since 06. But can't decide for sure. What do you guys think?

Any other suggestions from experience or word of mouth?