Good news...? Platelets and Hb decreased

[paulaespada]

Hello!


For those who don't know or don't remember my husband was diganosed with AA on June 2008.
He was submited to ATG treatment and has been on cyclosporine since then.


Last week my husband had another consultation.
His values are: Platelets 156 (in July they were 190); Hb 13.5 (in July it was 14.5) and WBC 4.8 (in July 4.0).

Doctor decreased cycloporine from 120 mg/day to 50 mg/day and says that if my husband goes on like this he'll stop cyclosporine in January.

Now I wonder if this decrease in Platelets and Hb are normal.
It looks like a great drop, from 190 to 156.

What do you think?

As always, thank you very much for your answers.

[Dick S]

I wouldn't worry too much. My platelets hover around 140-150 and I think that is a great number to have. Most MDSers fight to come anywhere near that number.

BTW a HGB of 13.5 is very good, I should be so lucky to have that high a number.

[paulaespada]

Hello Dick


Thank you very much for your answer.
But my husband issue is Aplastic Anemia, not MDS.

I wonder if it's normal to have his values decreasing after being higher.

[Lisa V]

Paula, is this the first CBC he's had since July? That makes it kind of hard to know which way the counts are really going. It may look like they are all decreasing, but they could have gone up and down within that time. If you could see that fluctuation I think you'd probably feel better. As it is, it looks like a sign, and I don't think that's necessarily the case.

At any rate, they're all still within normal range, which is the main thing. It seems he's had an excellent response to the ATG! Many AAers never return to full normal counts, so that is something to celebrate. Still, given that every line seems lower than the last reading, if it were me I'd want to see results more often, just to gauge if it really is a downward trend. Ken still gets CBCs every month, even though it has been several years since his last ATG. That way we know that a single lower count one month may not mean much if it goes up again the next month. Is there any way your husband can get more frequent CBCs?

Frankly, I'm more concerned that they're cutting his cyclo from 120 mg to 50 mg. AA doesn't like sudden changes. There seems to be growing evidence that a slow, gradual taper is very important in preventing a relapse. Ken relapsed after a fast taper and so have others that I've talked to. I think it's better if he can reduce it by the smallest increment possible, which may be 25 mg, then wait and monitor his counts to be sure they remain stable before going further.

[paulaespada]

Dear Lisa


Thank you very much!
Your answer makes me feel better.

Indeed he had no CBC since July in spite he should be called to a consultation here in out hometown in August. But they never made the appointment.

As you, I feel that cyclosporine tapping could be slower.

This only happens when wwe go to principal Hospital in Porto (here where we live he only is submitted to blood tests - no medication adjustment).

I will talk to his doctor there in Porto in January. I was not able to be in this consultation.

Anyway it's a relief to know that his values beeing in normal ranges are a good sign.

I will keep you updated.

Thank you again.