Hi Sarah,
Sorry for the delay in getting back to you. It was Thanksgiving Day in the US
I think that you are wise to consult a second opinion in England.
I would ask for a BMB because of the significant drop in your counts in multiple lines. Only with a BMB will they be able to tell if the drop is due to a transformation to MDS or if it is due to relapse. Also, I think it would be interesting to see the effect of Etrombopag on the cells in your marrow, especially if you are continuing with this drug. Because Etromopag can increase the risk of transformation to MDS, I would want to rule this out!
I was able to stop a relapse by restarting cyclosporine and am dependent on the drug to maintain my levels. Hopefully, restarting cyclosporine will work for you. If not, because you responded to rATG before, take comfort that you are more likely to respond to it again.
Good luck!