[lcl]

Well, its been 14 weeks and the results of the most recent biopsy show a cellularity of ~20%. While better than the 10% that was tested in January the doctor noted that the marrow is more or less unchanged. No clonal issues at this point which is good. We have no sibling matches and no perfect unrelated matches so the 2 choices are haplo BMT or hATG with PROMACTA and cyclo. We are going to parallel path and start a 2nd round of ATG in 2 weeks and this time add the PROMACTA (Eltrombopag). The BMT team will start working up a protocol now and we will give the next round of IS another 3 months to see if it takes. Tough call given VSAA with ANC sub .10, weekly transfusions and high end on the neutropenic spectrum but supportive care thus far has been working well with only a few hospitalizations. Will provide an update 6 weeks into the new IS with PROMACTA added, hopefully it spurs the marrow to start growing back.