Hi Julianna,
When you first posted your comment that your doctor thought immune suppressant treatment caused the progression of AA to MDS, it jolted me a little. I did some Google research at that time and found some articles that seemed to think that ATG in combination with G-CSF may increase the probability of transformation. Other articles said that there wasn't a connection. So, it is still being debated and studied.
http://bloodjournal.hematologylibrar...10-01-234120v1
I read some other articles that had another theory that MDS/PNH may have already been there, but undetected, at the time of diagnosis. The immune suppressant treatment addresses the AA issues, but the MDS/PNH issues remain untreated and slowly expand, which is why it shows up later in life. Again...just more theories. Do you know if you had an signs of MDS at the time of your diagnosis?
I had proposed the question about long term immune suppression resulting in increased risks of transformation to my doctor, and he had said that ATG/CyA are used in transplant patients, yet the same is not seen. I don't know about G-CSF though.
I have a quesiton for you...how long were you on Cyclosporine the first time around? Did you relapse after stopping it? When you had a partial response, what were your counts at their best? My doctor said that it is unusual for people with a partial response to not relapse rather quickly, which is why I'm still on the cyclosporine. I'm encouraged though that you were stable for 14 years with a partial response!