Home         Forums  

Go Back   Marrowforums > Bone Marrow Failure Diseases > AA
Register FAQ Search Today's Posts Mark Forums Read

AA Aplastic anemia

Reply
 
Thread Tools Search this Thread
  #1  
Old Tue Sep 6, 2011, 03:47 AM
pvinod pvinod is offline
Member
 
Join Date: Mar 2011
Location: India Gujarat Ahmedabad
Posts: 39
what is better in 2nd ATG? repeat H-ATG or try R-ATG?

Hi My daughter had an H-ATG in Dec-2010. but still no response. Nutrophil is only 6 and lymphocytes is 93.

so in 2nd ATG what is better? Is it good to repeat H-ATG again or do we have to try R-ATG?
__________________
Kavya; my daughter age 4.5; diagnosed AA 2010; treated with ATG in December 2010; currently on cyclosporine; 6 month over for ATg but still transfusion dependent;
Reply With Quote
  #2  
Old Tue Sep 6, 2011, 04:07 PM
Karenish Karenish is offline
Member
 
Join Date: Feb 2011
Location: Stafford, United Kingdom
Posts: 100
I think they will try horse as she had horse first. i am the same, nothing really major in my counts, so we are looking at rabbit again as it was rabbit first. I think they stick with the same because they know how the body will react to it, but i am sure someone more knowledgeable may know. However, get them to check for any cellular activity in her marrow first, some people dont respond until month 10 I have heard but checking may show that there is a response but it is slow. good luck, i do know how it feels to be ever hopeful at every blood test only to be disappointed with each call, saying they are going down again, and in you go for yet another transfusion. I am getting two bags of plates again tomorrow....been 15 days since my last one!
Reply With Quote
  #3  
Old Tue Sep 6, 2011, 04:46 PM
Lisa V Lisa V is offline
Member
 
Join Date: Aug 2006
Location: Waimanalo, Hawaii
Posts: 401
This is a very difficult question to answer. If your daughter had shown a response, even a small one, to the first round of H-ATG, then I'd say to repeat the horse. That's what we did, and I'm glad we did, particuarly since recent studies have shown that H-ATG is more effective than R-ATG as a first line therapy.

On the other hand, R-ATG is still useful for salvage therapy, meaning when the first line of treatment hasn't been successful. I'm not sure whether or not it would be worth trying again with the horse in this case. I think if we had seen no response at all the first time we might have switched, but I imagine every doctor has their own opinion on this.

Has anyone else come across any recent statistics on horse vs. rabbit for salvage therapy? I tried searching and couldn't find anything.
__________________
-Lisa, husband Ken age 60 dx SAA 7/04, dx hypo MDS 1/06 w/finding of trisomy 8; 2 ATGs, partial remission, still using cyclosporine
Reply With Quote
  #4  
Old Tue Sep 6, 2011, 11:41 PM
Hopeful Hopeful is offline
Member
 
Join Date: Jan 2009
Location: California, USA
Posts: 766
Hi Lisa and pvinod,

I remember from one of the conference speakers that Rabbit ATG is typically used for salvage treatment because of the fear that a patient may have a more severe reaction to the therapy the second time around (like anaphylaxis shock). One of the people in the audience commented that this had happened to her! There haven't been official studies comparing the two at NIH.

The response rate to a second course of ATG in a non-responder is about 1 in 3 - not as common as the first course, but still possible.
__________________
55 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. small trisomy 6 clone, low-dose cyclosporine dependent
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
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
Update - my husband 1 year after 2nd ATG paulaespada AA 3 Mon Jul 18, 2011 07:07 PM
Trying to decide on BMT or 2nd ATG bochs4 Tell Your Story 16 Tue Mar 8, 2011 11:49 PM
2nd ATG just 2 years after the 1st paulaespada AA 11 Wed Aug 18, 2010 09:42 PM


All times are GMT -4. The time now is 10:47 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