[Marlene]

IMO....Looking at these numbers leads me to believe that your sister did have a response to the ATG. But I will ask for other members with experience with ATG/Cyclo to give their opinion. Her ANC and platelets are up and if I remember, she's not getting any platelet transfusions. Depending on when her last red cell transfusion was, it looks like her red cells are up also. Another way to check red cells is to have them run Reticulocyte count. Again, they should get a percentage as well as an Absolute Retic Count. Reticulocytes are new red cells and this number would be elevated or higher than previous levels if she making her own red cells.

Even though you saw a drop in the ANC this last CBC, I would not try to interpret that as problem at this point. She has a normal ANC with the help of the growth factor. You always have to look at trend and not rely on just one CBC. Counts fluctuate all the time in everyone. That's a normal thing.

Personally, I would wait on a BMT if this trend continues. You can live a very safe life with these counts. At 50K platelets, you can have surgery without needing a platelet transfusion. Her White Count is normal with growth factors. (The WBC/ANC can drop 50 -70% when you stop the growth factor. That's scary but not bad as long as it stays in the safe levels). Red Cells look like they are also functioning.

But again, this is my opinion and it would be good to hear from others.

Marlene