[Matthew42]

I have a bit of an update:

We didn't know this, but my mother's hematologist consults with Dr. Neal Young at John Hopkin's concerning my mother's aplastic anemia.

Dr. Young confirmed that my mother is indeed responding to IST therapy, even though she is still transfusion-dependent at 15 weeks post horse-ATG. The hematologists have decided that they want to give her another 6-8 weeks before doing a rabbit-ATG. There's still a real chance she could have a full response to horse in the coming weeks, they said. They also saw a little improvement in bone marrow cellularity, along with the fact that her neutrophils almost reached 1000 at a few weeks ago. They also highlighted the fact that slower drops in hemoglobin between transfusions are also a sign that there is some improvement. She definitely has autoimmune aplastic anemia (I never knew that aplastic anemia can be less autoimmune). And the slow response to horse-ATG is most likely to due to only having 5% cellularity in bone marrow, as well as the fact that she is much older than the average aplastic anemic.

Everything looks pretty good so far, but they said she may still need the rabbit "to bring her over the hump"; and her hematologist and Dr. Young say it is not at all risky for her to have rabbit in the coming months, if it comes to that. Why? Because she did well with the horse-ATG administration. The rabbit is just a bit stronger. They would give her longer than 6-8 weeks to see if she has a full response to horse-ATG, but Dr. Young is concerned about staying on blood transfusions at her age. Even though she is otherwise healthy, it's harder on older people. The older you are, the more likely you are to get complications from blood transfusions, especially the iron overload.This is why the hematologist was adamant at the last appointment on doing rabbit in the coming months. It's all because of her age.

By the way, the reason my mother had no transfusions for 3 weeks after ATG was because of the prednisone she was taking. This also proves that her aplastic anemia is very autoimmune in nature somehow.

Only got bad news on one front: She now does have iron overload from getting so many RBC transfusions. It's over 3000! But they've seen many patients with way higher than that. She has a bronze color and little appetite, so that's the reason. But they are going to wait a month or so see if it comes down before doing Exjade. They also want to do a liver MRI to make sure there is no liver damage because she had a liver issue a few months ago (drug-induced liver injury). Her liver panel has been real good so far. So we're going to do wheatgrass, turmeric and quercetin. It's better to try the natural route. Her doctor is not against supplements. It's not necessary to bring it down to under 300 -- just under 1000 or so. A lot of healthy people have iron amounts that are close to 1000, even though it's out the normal range.


Health and happiness to everyone!