SAA - recovery question

[clairekim]

Hi All,

It's been awhile since I last visited this forum.

My wife was diagnosed with SAA last October and received her ATG during Thanksgiving break. Her counts were really bad (for sometime her platelet count dropped to 1!!). She has been transfusion dependent for about 8 weeks and then the counts slowly moved up. Her platelet count moved up very quickly to reach 79K in mid Feb. However, her platelet count then started dropping. Now she's at 55K. Her WBC and RBC are also in slow decline.

Has anyone seen this behavior? Is it a bad sign?

BTW - my wife is on 3X100mg of Cyclo per day. We haven't tried to taper it off or anything.....

Thank you.

[Neil Cuadra]

David,

Many patients who receive bone marrow transplants experience an unexplained but temporary drop in counts about 70 days after the procedure. My wife was one of them. If the same type of delayed reaction happened to your wife after ATG, then 70 days would be in February, which matches when you say her counts started to drop. Whatever the reason, you are right to be concerned if the decline isn't slowing or reversing.

Over how many blood tests in the last month have you observed a decline in her counts? A single test doesn't indicate a trend, but if it's been a series of tests with continued declines then it's time for a conversation with the doctor about what to do next.

[Hawaii Bill]

Hi Clairekim,

Just wondering if the type of Cyclosporine she is taking has changed???

My doc only prescribes Neoral. There are other brands/types: Gengraf and Sandimmune. They are not all the same, and changing brands midstream could cause problems, I think.

Happy to hear that she has responded so well!

Bill