[Logain]

Hello,

A short prelude:

My wife has had SAA about 5 years ago, she's been treated with rATG&Cyclosporin (1 year taper) with excellent results.
She's been cyclo-independent for nearly 3 years now.

Even after stopping cyclosporin, her counts kept climbing (all 3 lines) steadily, with a peak of 180 plts in March/2015.

Two months later, her PLTs began dropping steadily, with an additional drop in hemoglobin in the past few months. A BMB affirmed a relapse.
Her current PLTs are 70, and hemoglobin is 11.

Now, we are faced with 3 options:

1. Another round of ATG. Our least desired option as - from what I've learned - one relapse will lead to another, and a second round also involves a much more significant risk of PNH and MDS. So this solution is basically just a short postponing of the disease for a later time, and with more dire consequences.

2. BMT. She has an unrelated donor that is 10/10. This is our current course, but the significant risks of GVHD caused us to try looking for other options.

3. Pray hard.

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Now, to my questions:

1. What are your opinions of the information provided? Does anyone disagree with any of the aforementioned solutions or know of other solutions?

2. Has anyone had any experience with patients who relapsed, and had a full recovery afterwards?

Thank you so much, every bit of information would help immensely.