ATG used,not response yet

[vicid]

Father took ATG on december 18th, no development yet, approximately 2,5 months passed. Still he goes to hospital to take platelet and red blood cell, every week. 5 units platelet and 1 unit blood. What should we do now, continue to wait for any response or take another ATG, Why do we have to wait 3 months at least, can any change in blood test show a response.




father hypocellular MDS or Aplastic anemia for 8 months. Danazol used, no benefit, ATG and sandimmun,now waiting for response.

[emmajennions]

Hello, sorry to hear about your dad. My name is Emma im 22 and also have Aplastic Anemia/ Hypo-plastic MDS. I had ATG treatment in Nov 09 and also have still had no chances in counts. I waited 4 months and am now being reviewed for a second dose. If i were you I would wait a little until the 3-4 months have passed and go from there. If he has no changes he will probably need another bone marrow biopsy before a second dose of ATG to check if there are any changes in the marrow following the treatment, I am having mine shortly.

Good luck to you and your father, best wishes x

[vicid]

for two months my father dont take platelet transfusion, and his last measurement of platelet is 30k. on the other hand he is continuing to take blood transfusions every 2 weeks. creatinin levels are increasing, his drugs are sandimmun and exjade. Also has hip pain I dont know why, can MDS/AA coexists with multiple myeloma

[m mindas]

steroids that are given with the ATG treatment to avoid serum sickness can sometimes cause necrosis of the hip joints. I also found that I had muscle cramps (of the neck) when i was taking cyclosporine..Good luck and i hope all counts stabilize for your dad.

[evansmom]

Originally Posted by vicid

for two months my father dont take platelet transfusion, and his last measurement of platelet is 30k. on the other hand he is continuing to take blood transfusions every 2 weeks. creatinin levels are increasing, his drugs are sandimmun and exjade. Also has hip pain I dont know why, can MDS/AA coexists with multiple myeloma

Hi there,

My son had an extremely serious reaction to cyclosporin (sandimmune is same drug) after his BMT for AA. It's a rare reaction called Microangiopathy and docs often don't recognize it. Rising platelets, extreme drop in red blood cells, and increasing creatinine levels are all signs of this. Ask your father's doctors about this, ask if he has "red cell fragments on the smear", ask to have an LDH level done, and if this is routinely done anyway, ask if this LDH level is high. These are diagnostic factors for Microangiopathy and if your father has this, he'll need to be switched to another immunosuppressant that is NOT a calcineurin inhibitor (cyclosporin, tacrolimus) like Cellcept.

This may not be your father's situation at all but I wanted to pass these ideas along.

Best wishes,

[vicid]

My father is platelet transfusion free for three months, I dont know what is it reason. maybe cortizone or ALG(late response), Platelet is now 30 continue to take hemoglobin for 2-3 weeks, cortizone off now because of the side effect, osteoporosis. Now it is planning to make horse ATG treatment maybe 2 months later. Also there are some other diseases like embolisis.And there was kidney problems.kidney creatinin levels are decreasing because we decrease the cyclosporine from 250mg day to 200 mg.

[pvinod]

Hi vicid ,

I hope your father is fine now.

I just want to know about him differential WBC count specially neutrophils and Lymphocytes in percentage before ATG, day1 of ATG and after 2 month of ATG.

i want to compare it. Please share it.

[vicid]

Before atg neutrophils were lower but after ATG neutrophils comprised 70% of WBC

[Kevin88]

Was the neutrophils the first sign of improvement? My hisband had ATG February 2019, still no sign of improving the hemoglobin or platelets. His neutrophils have increased a lot though. They are currently at 1.74.