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Hi Ryan,
Happy to report I have an answer to your question directly from NIH, and in short that answer is "yes, even a month later a patient's blood can be low from the phlebotomy, without it signifying anything adverse like relapse".
This is from an AAMDS webcast from San Francisco a few weeks back with Dr. Townsley from NIH, discussing the latest non-transplant treatment options for AA. In her presentation she had a graph of refractory AA patients' hemoglobin response after an Eltrombopag clinical trial (you may have heard how promising this new drug is looking to treat AA). Anyway, a number of the patients achieved normal Hgb counts. One patient went up over 15, and then started falling over a series of about 5 months down to 12. Dr. Townsley asked us a 'bonus question' - "now what's going on with this patient?". The answer was phlebotomies. I was surprised to see the patient had such a good response to treatment, yet fell so much in Hgb over a series of months from phlebotomies.
I think AAMDS has powerpoint docs out on their website from this webcast, and that may have the chart described above in there.
It is encouraging to hear you are doing so well 4+ years post-ATG.
Kevin
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Kevin, male age 45; dx SAA 02/2012 - Hgb 5.8, platelets 14, ANC 200, 1% cellularity. Received ATG 03/2012. As of 03/2015, significant improvement - Hgb 15, platelets 158, ANC fluctuates around 1000, Lymphocytes 620. Tapering cyclosporine. BMB 20-30% cellularity.
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