[tytd]

Hello McGill54,
I appreciate your dilemma with the low platelets and yours would appear to be a unique situation with your heart disease. Some patients may bleed at higher platelet counts than others depending on the function of the platelets which the aspirin affects in your case. Have you had any bleeding symptoms as that would make a difference in your decision? You have to weigh the risk of bleeding with any level of platelet count vs the risks of trying a drug whose full benefit/risk profile in MDS or CMML has not been fully tested. As you know the Nplate has only been FDA approved for ITP but is undergoing clinical trials in MDS patients. From what I have heard experts say, it has been shown to improve the platelet count in approximately 50% of patients but has increased the blast count to AML ranges in some patients which resolves when the drug is stopped. There is also the question of increased reticulin deposits in the BM and some other concerns. I have elected to "sit tight" with my low platelet count but would certainly consider getting into a clinical trial with Nplate or Promacta if lower counts or bleeding occur. I would be interested in knowing if your MD is able to get the drug for you off-label as I had heard it was only available through trials or if you had ITP. I assume that you have not been given any other drugs lately that would affect your platelet count. How long ago was your stent placed? Good luck tytd