1 year after ATG

[julieluvsmarco]

hi im new to posting but ive been reading posts for about a year.my daughter marie was diagnosed 6/27/2011 with severe aplastic anemia she was treated with atg on 07/12/2011,She started with a 10% cellularity having weekly platelet transfusions an bi- weekly blood transfusions.she has been on cyclosphorine for about a year.The last bone marrow aspiration was done Feb 2012 and showed 60% cellularity.she has been transfusion free for 6 months on both lines of blood.her wbc are at 6.7 and will go up if she has a little flu or what not, her hemoglobin lingers at a 10.5 but its steady. her platlets are lingering in the 30's and have fallen down to 15 but will rise on their own.my question is how long into the atg do platlets rise significantly.Our hemotologist tells us that the platelets are the last line to come back to normality.She says that shes doing great and its a waiting game. Im happy she is responding but also slightly confused. i would appreciate any input thanks in advanced

[NLJabbari]

Hi Juliet! Well congratulations...it sure does seem that your daughter is recovering quite well.

Re: platelet count, well I have read of other cases familiar to your daughters. The platelets do seem to rise albeit slowly, but surely. I also just wanted to mention that platelets are not necessarily the last line to respond. I think that for a large majority this might be the case, but for a few others the platelets are the first line to respond. I only say this because that was what happened in my son's case. His Hgb was last to rise and is always first to drop too! I never quite understood why a few people experience this and others don't.

Anyway, hope this helps

[Lisa V]

Juliet, I agree it sounds as though your daughter is doing well. As Norma said, platelets are not always the last line to respond, but it seems they are often very slow to bounce back. What you have to remember is that AA is not a single homogeneous disease, but rather a group of syndromes that share a similar set of symptoms. So one person's pattern of response my differ from another's.

Ken's Plts never rose above the high 20s his first time around. He relapsed when the cyclosporine was tapered, and had his second ATG a year and a half after the first. He showed a better response the second time around, but still slow. Here are his Plt counts at annual intervals, starting with 1 year after ATG.

1 yr: 56
2 yrs: 73
3 yrs: 113
4 yrs: 117
5 yrs: 127
6 yrs: 140

So basically for him it took 6 years to reach normal range. We relaxed a little once it hit 50, and when he got to 100 it was cause for celebration! He's been on a maintenance dose of cyclo all this time to avoid another relapse. His WBCs are still on the low side, however, so your daughter is doing better in that respect.

Hope this helps.