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Old Sun Aug 7, 2011, 11:27 AM
amberb amberb is offline
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Location: Jacksonville Beach, FL
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WBC and ANC fluctuating after ATG

I completed four days of ATG (horse serum) on July 22, 2011 and am currently on cyclosporine. During treatment my WBC dropped as low as 0.3 and my ANC as low as 0.5. One week post-treatment my WBC was 2.8 and ANC 1.7. I was very excited to see my numbers start to improve so quickly, even though I still needed a platelet transfusion (Plt count was 7 that day) but then just four days later my WBC dropped to 1.8 and ANC to 0.7, and again to 1.3 and 0.5. The Drs said my numbers would fluctuate, but has anyone else experienced this? I know it's only been two weeks since completing the ATG and it can take anywhere from 3-6 months to know if it's working, but I don't know what other people have experienced with this...
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Amber, age 24, diagnosed w/ SAA and treated w/ horse ATG 7/11, rabbit ATG 1/12, on cyclosporine. Started Desferal infusion for iron overload 7/12.
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Old Wed Aug 10, 2011, 07:32 AM
JodyW JodyW is offline
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Hi Amberb,
I can't tell you the science behind why this works this way, there are others on here who may but I can tell you its not much different then my son or many others I read about here. Trevor is your age and had his ATG in late March. We stressed over the numbers everytime they came out which at one point was 3 x week. We would try to understand why this number went up or that number went down over and over. At about 4 months Trevor was independent of transfusions and his numbers began to stabalize. He now gets them drawn every 2 weeks and they still go up and down. Here are his numbers for the last 3 cbc tests over a 4 week period. WBC- 3.6,2.4,2.9-- Hgb- 9.6 , 8.6, 8.6--Plt-100,98,113 ANC- .8,1.0.. As you can see almost 6 months later the numbers go up and they go down. It is also clear to us now that the 3-6 month thing is really just getting started. This is a longer road than that but you can do it. Talking to people on this forum, knowing that there are others with the same thing going on, helps relieve some of the stress about this. You hang in there. Hope that helped.
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Jody, mother or Trevor 23. Diagnosed VSAA 3/11 , ATG cyclosporin 3/11 response 6/11, Relapse 1/13, Round 2 ATG 1/13
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Old Wed Aug 10, 2011, 07:36 AM
JodyW JodyW is offline
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Hi Amberb,
One other thing, Trevor's ANC was a low as .01 , his Ptl were at 11 and Hbg at 2.2 so you can see the numbers can go pretty low before they go up.. Hang in there.
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Jody, mother or Trevor 23. Diagnosed VSAA 3/11 , ATG cyclosporin 3/11 response 6/11, Relapse 1/13, Round 2 ATG 1/13
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Old Fri Aug 26, 2011, 03:57 AM
Darija Darija is offline
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HI Ambererb,
I started ATG the exact same time as you!
My counts have been fluctuating ever since. The highest they reached was WBC 2.9 and two weeks later they dropped to 1.4. My platelets ranged from 20 down to 10. The doctor speculates that it is because we are still trying to find a proper dosage amount for the cylcosporine, and I have been on and off the prednisone, but it is indeed so frustrating and discouraging at times. Hang in there, I know I'm trying to! How are your counts now?
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Old Sun Aug 28, 2011, 11:00 AM
amberb amberb is offline
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Location: Jacksonville Beach, FL
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My ANC is fluctuating between 0.2 and 0.5, so i'm on Levaquin, Valtrex, and Diflucan until it comes up over 1.0 and still have to continue neutropenic precautions. my WBC is 1.2 most recently, but 4 days prior it was 2.2. my platelets will go up to the 40s after a transfusion, but within a week be under 10. i've been having platelets every week and a blood transfusion every other week. they check my blood twice a week, and it's different every time.
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Amber, age 24, diagnosed w/ SAA and treated w/ horse ATG 7/11, rabbit ATG 1/12, on cyclosporine. Started Desferal infusion for iron overload 7/12.
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Old Mon Aug 29, 2011, 06:51 AM
edithr edithr is offline
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Erics counts went up temporarily too after ATG, I attributed it to the steroids he was taking.
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Edith, mom to Eric, dx 2/11 at age 15 with SAA, began ATG/CsA 3/11, switched to Tacrolimis 8/11, off all meds 9/11 and is now considered to have bone marrow failure not otherwise specified.
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