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Hi StephM,
That is good that he doesn't have PNH. PNH is not something that you need to check often. I was just curious if they did check it, since his urine was so dark.
Your English is so good that I forgot you are French! The trough measurement refers to the lowest level of cyclosporine in his body. Cyclosporine generally follows a bell shaped curve after ingestion. The peak levels are ~2 hours after taking it. The lowest levels are 10-12 hours later, or just before taking the next dose. Doctors usually check this lowest level (or trough) to make sure that a patient is not on too high or low a dose of cyclosporine. This is all very controversial, as some people metabolize the drug very quickly. It would be interesting to see what level your brother is at because his dose is so low. If the cyclosporine "trough" reading comes back really low, you may have an argument to increase his dosage. Typically, doctors like to see it around 200. If it is above 400, he is taking to much of the drug. If it is below 50, he may not be getting enough. Anything in between is another data point, in my opinion.
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55 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. small trisomy 6 clone, low-dose cyclosporine dependent
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