Home         Forums  

Go Back   Marrowforums > Practical Issues > Questions and Answers
Register FAQ Search Today's Posts Mark Forums Read

Questions and Answers Not sure where to post a question? Post it here.

Reply
 
Thread Tools Search this Thread
  #1  
Old Wed Mar 10, 2010, 12:50 PM
Lamilu Lamilu is offline
Member
 
Join Date: Feb 2010
Location: Edmonton, Alberta Canada
Posts: 32
How soon for ATG to work?

My mom had ATG the last week of February. This morning she went for her routine blood work and all her counts are down accept her Platelets, they have gone up to 53 from 9 on Monday. She did have a Platelets transfusion yesterday but her counts have never gone up this high before. usually with a transfusion it would bring her Platelets up to 18-20 for about 4 days. Could the ATG being working already this soon? She is also on Cyclosporine and steroids. Her doctor actually put her Cyclosporine up to 400mg a day on Monday which I thought was strange because she was only home about a week. Is this standard? She is 117lbs. Thanks in advance!!!

WBC 2.6
Neutrophils 1.1
Hemoglobin 82
Platelets 53
__________________
Daughter to Sharon 68 dx SAA Feb. 2010 ATG, Cyclosporine & Prednisone.
Reply With Quote
  #2  
Old Thu Mar 11, 2010, 10:05 AM
Lamilu Lamilu is offline
Member
 
Join Date: Feb 2010
Location: Edmonton, Alberta Canada
Posts: 32
update

I guess the doctor said that my Mom just probably got a good batch of Platelets. Has this happened to anyone else before? i was really hoping that it was a good sing. Anyways, the doctor says my Mom is doing good so far but that her counts haven't dropped down enough yet to indicate the medications are kicking in. This is a little confusing. Are they not supposed to be going up? I'm still wondering about the Cyclosporine dosage. If anyone could comment on that I would appreciate it very much. Thanks!!!
__________________
Daughter to Sharon 68 dx SAA Feb. 2010 ATG, Cyclosporine & Prednisone.
Reply With Quote
  #3  
Old Thu Mar 11, 2010, 12:05 PM
Hopeful Hopeful is offline
Member
 
Join Date: Jan 2009
Location: California, USA
Posts: 718
Hi Lamilu,

Some of the older protocols used much higher doses of Cyclosporine (12 mg/kg/day) for 6 months and then stop abruptly. Some newer protocols follow 5 mg/kg/day for longer lengths of time (years). Your mother's protocol seems like something in between. Be sure her Cyclosporine trough level is being checked frequently to ensure it isn't exceeding the maximum and that she is getting a comprehensive metabolic panel to ensure her kidneys and liver are tolerating the dosage. It will may take a few weeks for the Cyclosporine to build up to toxic levels, so check frequently.

I would ask the doctor what the long term plan is for her Cyclosporine regimen. I've heard that dosages above 5 mg/kg/day provide much toxicity with little added benefit. Be proactive about checking her troughs and metabolic panels and requesting to lower the dosage if concerns arise.

Stay positive!
__________________
52 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. Tried slow cyclosporine taper over 4+ years. Platelets fell, so back on cyclosporine. Trisomy 6 clone in 5% of cells.
Reply With Quote
  #4  
Old Thu Mar 11, 2010, 12:47 PM
Lamilu Lamilu is offline
Member
 
Join Date: Feb 2010
Location: Edmonton, Alberta Canada
Posts: 32
Thank you

Thank you for your reply. I called my Mom and asked her about the Trough levels and she is being monitored for the trough levels as well as the kidneys and Liver once a week. So I guess all is going as it should be. Thank you so much
__________________
Daughter to Sharon 68 dx SAA Feb. 2010 ATG, Cyclosporine & Prednisone.
Reply With Quote
  #5  
Old Fri Mar 12, 2010, 06:12 PM
Lisa V Lisa V is offline
Member
 
Join Date: Aug 2006
Location: Waimanalo, Hawaii
Posts: 401
Lamilu, I've heard other patients talk about big differences in batches of platelets. It can either be a freshness issue, or one of compatibility. Fresher is better, as platelets expire quickly. Blood type doesn't matter for Plt donations, but certain donors may be more compatible for other reasons. When Ken was getting transfused, his average Plt boost from a tx was usually up to about 45k, so 53 doesn't sound too unusual to me. Now, if it goes up from there without another transfusion, then that would be a sign.

I'm not sure what the doctor meant about her counts not having dropped enough yet. It is not uncommon for them to go down before going up, but I've never heard of any specific amount that they are supposed to go down, or of that being proof that the medications are working. I always figured you knew they were working when you start having longer intervals between needing to be transfused, and then stop needing it altogether.
__________________
-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
  #6  
Old Sat Mar 13, 2010, 10:11 AM
Lamilu Lamilu is offline
Member
 
Join Date: Feb 2010
Location: Edmonton, Alberta Canada
Posts: 32
Thanks for your response. Yeah we are still confused about the counts needing to drop more first. He told her "things need to get worse before they will get better". Just have to wait and see I guess. I know her doctor is a Hematologist and is familiar with bone marrow diseases but no one here (Edmonton Alberta) is familiar with Aplastic Anemia. Every time my mom goes for transfusions the nurses ask her all kinds of questions about it to try and understand it more. Thanks again.
__________________
Daughter to Sharon 68 dx SAA Feb. 2010 ATG, Cyclosporine & 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
Will Dacogen work longer than 2 years? rich MDS 5 Sat Nov 4, 2017 06:00 AM
PNH impact on work MyraN PNH 2 Tue Oct 20, 2015 06:30 PM
American Disabilities Act-Part time work donna j. Insurance, Finances, Disability, Veterans Benefits 1 Wed May 16, 2012 05:44 PM
Questions at Work?? Deanna16 Insurance, Finances, Disability, Veterans Benefits 0 Mon Feb 22, 2010 09:29 PM
Where will my money come from if Iím too sick to work?, June 11, 2009,Toronto, ON Doug Mylie Canada 0 Sun May 17, 2009 03:16 PM


All times are GMT -4. The time now is 03:45 PM.


Powered by vBulletin® Version 3.6.7
Copyright ©2000 - 2019, 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 © 2006-2019 Marrowforums.org