[vicid]

My father has been MDS or AA, for approximately ten years. In this period he faced many difficulties. Hip replacements, liver tuberculosis and pyoderma gangrenosum(arms to fingers) and finaly splenectomy.
he has been doing well with low platelets and hemoglobin levels until now.
He took ALG(rabbit) in 2009 8 months later he became transfusion free of platelet(>20) but continue to take blood transfusion in every month and continue to sandimmun medicine and excade medicine for ferritin removal . In 2013 during hip replacement surgery I recognized that father has sleep apnea and started to use CPAP machine. After that he became transfusion free of red blood cells. In 2015 his liver became tuberculosis and at the same time his arms become pyoderma gangrenosum(top skin of arms were beleeding and dissolved which was too difficult to bear.) He used tuberculosis medicine and thalidomide to balance blood cells. After 4 months he was healty and had high blood cells for two years(HGB around 14). In 2018 october he had splenic infarct and experienced splenectomy.
MCV was very low around 70 and HGB was around 12 before splenectomy.
Platelet was around 10-20 which doesn't cause bleeding because if it counted manually it seems that it is higher than 20.
After splenectomy MCV started to increase to 80s and HGB decreased to 8.
We were expecting to see increased levels of HGB after splenectomy but it decreases.

I read somewhere that spleen can produce red blood cells. Maybe up to now spleen was producing red blood cells and HGB levels will continue to decrease.

Any idea?