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Fast Taper of CsA vs. Slow Taper
In response to HOPEFUL.....
My daughter has had two rounds of IST (no response the first time, we started with Rabbit). She had her second round at NIH with Dr. Young (used Horse ATG this time). She has, what they consider a partial response. She has been transfusion free since March of 2010. Dr. Young (who apparently wrote the book on AA and conducts all the trials) put Mia (my daughter) on a fast taper. She finished her Cyclosporine on September 7, 2010. Her numbers have been holding and even climbing a little bit.
However, I just read an article in the AA&MDSIF Insider Newsletter where Dr. Young summarized the newest research findings on AA and its treatment. (Published in the January 2010 edition of Biology of Blood and Marrow Transplantation). "There are several late complications that can occur after IST, Relapse occurs in up to 30% to 35% of patients when CsA is withdrawn at six months. A more prolonged course of Csa with a later slow tapering of the drug reduces the relapse risk to around 13% to 16%. About a third of patients are CsA-dependent and require a small dose long term."
Interesting that he wrote the article in January and in April advised us to use a very fast taper. All is going well for now....so we will keep our fingers crossed. The less drugs my daughter is on, the better!!!!
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Candy, mother of Mia age 17, diagnosed SAA January 2009; treated with ATG (Rabbit) in 3/2009; treated with ATG (Horse) in 10/2009; Finished a fast taper of cyclosporine (recommended by NIH on 9/7/2010). So far, partial response.
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