[Lisa V]

Ken gets Procrit, which as Marlene says, is another synthetic EPO product. Aranesp is the same thing, just longer lasting. Aranesp is normally given every two weeks, whereas Procrit is usually given weekly.

EPO drugs don't work for everyone, and some doctors won't even try it on AA patients because AAers tend to have an overabundance of their own EPO (erythropoeitin) produced by their kidneys in response to the red cell crisis. Our doctor wasn't very optimistic that it would work but decided to try it just in case, and it's helped him a lot with no side effects that we are aware of. Following his first ATG his Hgb got into the 10-11 range before he relapsed, but following the second one it rose to normal range. He's been able to maintain 12.5-13.5 levels while gradually cutting the dose to one fourth what he started out with. Obviously the ATG/cyclo has played a big part in this recovery, but every time we skip the Procrit for very long his Hgb starts to slide downward, so we know that's part of the equation too.

Interestingly enough, we had cause recently to give him an extra dose (we were going on a trip and wanted to "juice him up" before we left so we wouldn't have to travel with the drug) and his platelets suddenly bumped up a full 10k, which he has maintained too. I don't know why his Plts would respond to it at all, and our doctor and pharmacist don't either, but they said that occasionally it does happen that other lines are affected.

I asked our doc about the dangers because I had heard that growth factors can help spur transformations and tumor growth. He said that the risks he was aware of usually arose as a result of using it to push Hgb ABOVE the normal range, and as long as you don't do that he didn't think it was a problem. My impression is that this is a bigger issue with G-CSF/Neupogen than it is with EPO, but it pays to be aware of the possibility.