[DanL]

So I have been on the non-regimen of watch and wait for almost exactly 2 years. My doctor told me that I would probably know when it was time to begin treatment, and I think that I am there. Last week's CBC came out at:

WBC 4.8
Neutrophils 3.5 - 73%
Lymphocytes 24%
HGB - 12.3
HCT 38
PLT 20

Complicating factors - Trisomy 8, grade 2+ to 3+ reticulin fibrosis.

This is the first time my HGB has dropped below 13.5, though I don't really notice any impact - i did walk almost 7 miles yesterday without rest during or after the walk..... it is also the lowest my platelets have been. If somebody looks at me funny I bruise these days. WBCs have been pretty steady.

We have found 3 potential 10/10 donors, and my sister is a 9/10 match. I am considering beginning treatment with vidaza or dacogen to start and then moving to transplant.

My concerns focus on the marrow fibrosis and that i have found very few studies that determine if vidaza or dacogen improve marrow fibrosis, whereas revlimid and thalidomide, and even danazol have at least anecdotal references to improving marrow fibrosis.

Any thoughts? Am I too concerned about the fibrosis part of this equation? I know that collagen fibrosis is considered worse than reticulin fibrosis when it comes to transplant outcomes.

Thanks.