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Old Mon Jul 22, 2013, 07:03 PM
curlygirl curlygirl is offline
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Join Date: Jun 2013
Posts: 151
Quote:
Originally Posted by Hopeful View Post
Hi curlygirl,

Glad things are getting better!

For my benefit...did I do the cyclosporine calculations incorrectly or is your son on a high dosage as part of his protocol?

Also, are his doctors checking his cyclosporine trough levels to avoid toxicity?
Hopeful,

You calculated it correctly! They are using the dosage outlined by Dr. Neil Young in the article ssdavi71416 (Scott) linked to "How I treat acquired aplastic anemia" - "We initiate CsA on day 1 to a target trough level between 200 and 400 ng/mL, starting at a dose of 10 mg/kg per day (in children, 15 mg/kg per day).79" So our doctors started at that level and are then going to check and taper it each visit. We go back again tomorrow.

What I find fascinating about all this is that I notice that my son gets hemolytic anemia when his ANC drops below 200. That's only happened twice: once in May and again on ATG. Usually he is around 400. That actually sounds hopeful because secondary autoimmune hemolytic anemia tends to occur in lymphoproliferative diseases. That means his hemolytic anemia is probably secondary to another autoimmune disease, in this case the aplastic anemia. So it gives me hope that he will respond well to the immuno-suppressants.

Thank you for checking up on us! I will let you know what our cyclosporine end dose ends up being and if there are any effects on my son's kidneys.
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