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Old Tue Aug 16, 2011, 01:39 AM
Hopeful Hopeful is offline
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Join Date: Jan 2009
Location: California, USA
Posts: 766
I'm not a doctor nor do I work for the pharmaceutical industry, but I do think there is a role for cyclosporine alone for the treatment of MAA (which perhaps you have). However, it does need to be started early before the T-cell destruction gets out of control. MAA does not have as high a success rate with IST as SAA, and I believe this is because of the long watch-and-wait time between treatment and diagnosis.

In developing countries that don't have ATG, cyclosporine alone is used and has been proven to be effective for the treatment of even SAA. The success rate isn't as great as ATG, but if you are in watch-and-wait mode and things are slowly going downhill for you, it seems like a reasonable alternative to try. Here's an article about its success rate in developing countries:

http://www.ncbi.nlm.nih.gov/pubmed/16270758

The other reason why I believe that cyclosporine alone could work is that many of us need to stay on it for years to increase/maintain are counts. This is long after ATG has run its course. Cyclosporine may not be able to knock the big punch that ATG can do in the beginning. However, if you catch the disease early enough, perhaps you won't need that.
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55 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. small trisomy 6 clone, low-dose cyclosporine dependent
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