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Leah, when my husband was getting transfusions they used Hgb at 8.0 as a cut-off point. Ken never really felt the effects of low Hgb that strongly, but his doctor warned that anything lower than 8.0 puts too much strain on the heart and can cause other problems. Some people feel really tired at higher levels and may use a higher target for that reason.
If the EPO was working before, it seems logical to me to try increasing either the dosage or the frequency before resorting to transfusion. Often EPO drugs do stop working after a while, though. I would ask his doctor if he/she thinks that is the case, and if so, why?
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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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