cyclosporine as a first line treatment for MAA

[Emma J]

I am recently diagnosed with moderate aplastic anemia. All my blood counts are low but not in the severe range. I was followed for two and a half months with just blood tests. My platelet count was decreasing on a jagged track from 47 to 22.

It was decided to start me on cyclosporine alone with the idea that it would suppress the cells that were keeping my bone marrow from producing more wbcs, rbcs, and platelets.

It has been two weeks; I started on 600 mg/day (half in AM, Half in PM). My cyclosporine level as measured by blood test was 474 after one week. At the start of week two, the dosage was decreased to 400 me/day. My cyclosporine level was 453. Now after week three, my prescription has been changed to 300 mg/day (I haven't been tested for that level yet)

HAs anyone else been treated with cyclosporine as a first treatment for MAA? what were your results? How long did it take to get results?

Any side effectes? (I notice my kidney and liver values from blood tests have me worried - I haven't had a doctor's appointment to discuss them yet.

Thanks for any info you can share.
Emma J.

[Hopeful]

Hi Emma,

Cyclosporine alone is a reasonable first line of treatment for worsening MAA. It will take a few months for it to work - at least 2-3 months, and possibly more. So this will be a big test of your patience I have read studies where it is successfully used for the treatment of SAA in countries where ATG is not available.

I would get your cyclosporine tested again soon because your initial dosage was so high. It would be good to see that your kidneys are filtering properly now. A good maintenance dose is 5 mg per kg of body weight per day.

Cyclosporine is very hard on the kidneys when you are at high levels. Be sure to drink lots of water, avoid alcohol (and grapefruits), and get to a safe trough level.

Stay positive, and best of luck!