Home         Forums  

Go Back   Marrowforums > Treatments > Drugs and Drug Treatments
Register FAQ Search Today's Posts Mark Forums Read

Drugs and Drug Treatments ATG, Cyclosporine, Revlimid, Vidaza, Dacogen, ...

Reply
 
Thread Tools Search this Thread
  #1  
Old Fri Feb 27, 2015, 03:59 PM
Matt R Matt R is offline
Member
 
Join Date: Feb 2015
Location: Austin, TX USA
Posts: 1
Cyclosporine after ATG for AA PNH

I am a 45-year-old male who was diagnosed with AA with PNH September 2014 after BMB from 9/14 showed 10-20% cellularity and a small PNH clone (Clones of GPI-deficient cells identified among granulocytes (16.6%), monocytes (5.9%), and RBCs (1.1%)).

Previously had BMBs in Feb. 2014 and May 2014 that just showed a slightly hypocellular marrow that was recovering from an insult. Negative for MDS on all 3 BMBs.

I have a bone marrow donor identified (perfect 14/14 male MUD with same blood type), but my doctor wanted to try ATG/Cyclosporine treatment first. I had 4 days of ATG from 2/10 - 2/13/15 and had no problems other than hives the first night. Now I'm taking 400 mg cyclosporine and 60 mg prednisone per day along with antifungal, antiviral, and antibacterial meds.

So far, I'm handling all the medications very well, with just some tingling in my lips and occasional burning sensation in my hands when going from cold to warm temperatures. ANC had been as low as 0.2 at one point in September, but have mostly hung at or above 1.0 since then.

Just prior to ATG treatment, my CBC was as follows:
WBC 3.0, LY 1.6, ANC 1.2, Plt 44, HGB 9.8, MCV 115.7, RDW 16.5%.
3 days after ATG (2/16/15), CBC was:
WBC 3.3, LY 0.4, ANC 2.6, Plt 27, HGB 9.0, MCV 115.4, RDW 15.7%.
CBC from 2/20/14 was:
WBC 4.5, LY 0.8, ANC 3.6, Plt 25, HGB 9.5, MCV 117.6, RDW 16.5%.
CBC from 2/23/15 was:
WBC 7.4, LY 0.7, ANC 6.5, Plt 38, HGB 10.6, MCV 118.1, RDW 17.6%.
CBC from 2/26/15 was
WBC 6.2, LY 2.8, ANC 2.8, Plt 48, HGB 10.3, MCV 119.
My doctor is encouraged that the platelets and hemoglobin are coming back just 14 days after ATG. And it appears the lymphocytes were knocked down as they should have been for the first 12 days after ATG (were down to 0.4), but are now coming back up to 2.8. He thinks the treatment is working as it should, but says we'll just have to monitor it closely for 6 months on cyclosporine.

I am a little concerned about the MCV and RDW getting higher with each CBC, but they have always been high since I first started having funny results -- in March of 2014 my MCV was already 107.2 and has slowly climbed in the past year. My doctor says it's probably because my marrow is fighting hard to produce blood and it's probably creating large cells to make up for the lack of cells and occasionally making some mistakes. And there may be a lot of new large reticulocytes showing up in the CBC.

3 BMBs in the past year confirmed I had no signs of MDS, but I still worry about morphing into that. But I'm encouraged with the other counts and my positive response to ATG/cyclosporine so far.

Has anyone else with AA seen similar results with ATG/cyclosporine at this point (14 days post ATG)? Is it too soon for the lymphocytes to come back to 2.8? Did your MCV level rise and then taper off?
__________________
Matt, age 45; dx AA with PNH Sept. 2014; treated with ATG Feb 10-13, 2015; Currently on cyclosporine and prednisone.
Reply With Quote
Reply


Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
PNH increasing in size post ATG TASHMAC PNH 3 Sun Sep 27, 2015 10:00 AM
Increased PNH clone post ATG TASHMAC AA 3 Mon Jun 22, 2015 01:52 PM
please share lymphocytes counts before ATG, day1 of ATG and after 1 month of ATG pvinod AA 16 Fri Dec 30, 2011 03:32 PM


All times are GMT -4. The time now is 10:51 AM.


Powered by vBulletin® Version 3.6.7
Copyright ©2000 - 2024, Jelsoft Enterprises Ltd.
Forum sites may contain non-authoritative and unverified information.
Medical decisions should be made in consultation with qualified medical professionals.
Site contents exclusive of member posts Copyright © 2006-2020 Marrowforums.org