AA - What are acceptable values

[edithr]

My sons counts (after ATG and 6 weeks of Cyclosporine) are generally:

WBC 2.2
RBC 2.7
PLT 101
NEU .89

If these were the best the counts were to ever get, would that be acceptable? Would the doctors just do a wait and see, or do you think they would want to do another round of tx? In other words, since he is transfusion free, would they consider him moderate AA now?

Thank you!

[Karenish]

i would think this would be considered partial response, but the counts on average start to rise between 3 and 6 months after atg so you have a while to go yet to see him reach his true potential, but I personally would be pleased with these... mine just coming up to 3 months post rabbit are... hb 8 plates 11, wbc 1.5 and neuts .99 and not yet off transfusions, I was about to give up when consultant said they may just start to get their act together between now and the next 3 months so not to give up hope!
hold on in there I would say your son is doing well xxx

[Lisa V]

I agree with everything Karenish said. Those are pretty decent counts for 6 weeks out, and there's no reason to think they won't continue to improve, even if it is very slowly, over the next months and years.

Even if they don't, I doubt that they would repeat ATG as long as he's transfusion-independant. That is the criteria for "success", even if it's only a partial response. I think most of us here would consider Plts of 101 to be quite acceptable (it took my husband 4 years to get there!). You don't say what his Hgb is, but with RBCs at 2.7, I'm guessing around 10? That's not optimum, especially if he's very active, but it's liveable. Likewise WBC of 2.2. Ken's stayed in the 2s for years with no problems, although it would be good to see the neuts get a little higher.

If they appear to be stalling out at this level, you might want to discuss the possibility of giving him Neupogen to raise his ANC, and/or Procrit for his RBCs. They are both temporary measures, but can help fill in the gap until his counts catch up on their own. It worked for us.

Generally speaking, though, I say wait and see, and hope for the best!

[edithr]

Lisa V, it's like you've been there and done this before, you are exactly right with his HGB count - it's 9.7!

And he is (was) very active, he's more tired now. How much of that is from the disease and how much is from being a teenager, I'm not sure. I don't want him going through life with this energy level, I hope it gets better.

[KimO]

Edith, I think you have reason to be really encouraged with those counts. Shauna's platelets didn't hit normal until 3 months out or so and Hgb wasn't reliably in the normal range until 6 months -- and we felt she responded pretty quickly. Hopefully this is just the beginning for Eric and he will make a full recovery.

[paulaespada]

6 weeks after ATG this CBC values seems quite good.

As I posted in a new thread and you can find in others here (and in my blog), my husband values are very good now (nobody would tell how they were 1 year ago) but 6 weeks after ATG they weren't so good as those you post here.

Acceptable values depends on each person (there are patients that live well with 20 or 50 Platelets). The mark is if the person is free of transfusions or not.

So, keep the faith. I believe you're in the success path!

Wishing all the best.