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I see what you're saying, Bill. The age thing is a real Catch-22, particularly if you're right on the edge. There's nothing magical about the 40 year mark, but the younger you do it, the better. Also the fewer ATGs and transfusions you've had, the better. This makes it really hard to second guess whether to move forward right away when the odds are more in your favor, or wait and hope that you'll never have to. Bottom line, none of us knows what's going to happen, so you just have to look at statistics and weigh them against your own situation and hope for the best.
I'd still be inclined to give it more than 3 months, but if he has shown no measurable increase in counts (without the help of Neupogen, Procrit or transfusions) by the 6 month mark, and if he has a 10/10 donor ready and willing, that would be a strong incentive to pursue transplant.
If, on the other hand, his counts start to creep up, I'd wait and see what happens. And if a good match is not available, a second ATG would be preferable to an incomplete match.
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-Lisa, husband Ken age 60 dx SAA 7/04, dx hypo MDS 1/06 w/finding of trisomy 8; 2 ATGs, partial remission, still using cyclosporine
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