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Old Mon Apr 2, 2012, 04:56 PM
dfantle dfantle is offline
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Prednisone post ATG?

Hello, I completed my horse ATG this past Saturday and have a question regarding prednisone. I was given this 2-3 x daily the 4 days I was receiving the ATG, along with cyclosporine 2x a day, and an anti viral medication. However now that the ATG treatment is finished, I'm just on the cyclosporine, an antiviral and 2 preventative antibiotics until my white counts stabilize.

From reading the forums, it seems most people remain on prednisone post ATG and I'm wondering why and for how long?

Thank you,

Ps, had my 4th and last ATG dose Saturday and they sent me home 3 hours later as I had no adverse reactions with any of the doses. This was amazing because I totally failed the skin challenge test so my team worked with the NIH to create a protocol to allow me to receive the treatment and luckily i had no reactions while being infused. Hopefully this will be the case the next few weeks as well

Sent from my cell phone
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Dena
Age 54; DX Heavy Chain (AH) Amyloidosis 6/10; AutoSCT 3/11; Amyloidosis remission 6/11; DX SAA 7/11; Horse ATG 3/12; Mini MUD SCT 1/13; Recovered from SAA 5/13 & feeling great
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Old Mon Apr 2, 2012, 05:56 PM
Lisa V Lisa V is offline
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Dena, that's great that you've had no adverse reactions! Sounds like the tinkering with the protocol worked. I'll bet that's a relief!

You're not completely out of the woods as far as serum sickness goes, however. Hopefully you won't have any of that either, but it can occur weeks after the ATG infusions, which is why the prednisone is continued for a while. I think the usual time frame for the taper is one month (somebody correct me if I'm wrong). Ken had to taper off more quickly because he reacted so badly to it, so I'm not sure.

Cyclosporine is usually continued for about 6 months, but it can depend on other factors, such as how your response has been and what your counts are doing. They're finding that longer, slower tapers seem to be more successful.
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-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
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Old Mon Apr 2, 2012, 06:37 PM
dfantle dfantle is offline
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Thank you Lisa. This is what I thought I had read so I was surprised I wasn't given a prednisone prescription post ATG, as part if my hospital release plan. My doc is very experienced with this so I'll ask if I should have been.

Best,
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Dena
Age 54; DX Heavy Chain (AH) Amyloidosis 6/10; AutoSCT 3/11; Amyloidosis remission 6/11; DX SAA 7/11; Horse ATG 3/12; Mini MUD SCT 1/13; Recovered from SAA 5/13 & feeling great

Last edited by dfantle : Mon Apr 2, 2012 at 06:44 PM. Reason: Typo
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Old Tue Apr 3, 2012, 01:34 AM
dfantle dfantle is offline
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Hi Lisa, I checked with my Dr and sure enough the prednisone was supposed to have been prescribed by my hospital when they released me Saturday afternoon. Thankfully I only missed 1-1/2 days of it. Unfortunately that meant I had to take my dose tonight. Hoping it won't interrupt my sleep too much tonite.

Thank you so much for replying to my inquiry so quickly so I could reach out to my Dr and get the prescription before another day had gone by.

Best,

Sent from my mobile phone
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Dena
Age 54; DX Heavy Chain (AH) Amyloidosis 6/10; AutoSCT 3/11; Amyloidosis remission 6/11; DX SAA 7/11; Horse ATG 3/12; Mini MUD SCT 1/13; Recovered from SAA 5/13 & feeling great
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  #5  
Old Tue Apr 3, 2012, 02:13 AM
Lisa V Lisa V is offline
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Good, I'm glad you got that worked out! Sometimes you think there's a reason when the truth is somebody just forgot.
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-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
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