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Old Tue Dec 7, 2010, 12:05 PM
Hopeful Hopeful is offline
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Join Date: Jan 2009
Location: California, USA
Posts: 766
Quote:
Originally Posted by dhruba_bd View Post

From the above count what you think,
1. her condition is getting worse day by day?
I can't speculate on this.

Quote:
Originally Posted by dhruba_bd View Post
2. Can we say that Cyclosphorine does not work?
I think it is too early to tell one way or the other. *Early* response to ATG with cyclosporine happens within the first 3 months, but it can and frequently does take longer. Cyclosporine alone is not as powerful as ATG. So, it seems likely that it may take longer in some cases.

Quote:
Originally Posted by dhruba_bd View Post
3. She need to do BMT/ATG as soon as possible?
If she has a perfect sibling match, BMT is the first choice for treatment.
Otherwise ATG is the preferred treatment. Is this an option for you?
If ATG is unavailable, cyclopsorine seems like the next best thing. It is a treatment, and if her disease is immune mediated, should gradually slow the disease's progression.


Quote:
Originally Posted by dhruba_bd View Post
4. Is she is a severe phase of Aplastic Anemia?
The criteria for severe aplastic anemia are two of the three in a hypocellular marrow:
* Absolute neutrophil count less than 500
* Platelets less than 20k
* Absolute reticulocyte count less than 60,000 /uL

Don't get caught up in the staging. Since she is transfusion dependent, her disease is serious.

Also don't get caught up in weekly blood count changes. Look at the trends month to month.

Hopefully, her doctor will provide some reassurance at the next appointment. It would be good to understand why he thinks the diseases is immune mediated and may respond to IST.
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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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