Quote:
Originally Posted by Logain
Neil - thank you so much for the detailed and informative reply. Regarding the risks of repeated ATG, my source is this study (done in 1998). "The probability of developing a late clonal disorder was 53 +/- 10% after multiple, as compared to 34 +/- 7% after single exposure (P = 0.15)." |
I'm not convinced that that study showed a causal connection. It could instead reflect the fact that patients who underwent multiple ALG treatments were less healthy all along or more likely to have had conditions other than aplastic anemia in the first place. Some cases of MDS are thought to be aplastic anemia because of the overlapping symptoms and because the chromosome problems characteristic of MDS go undetected in hypocellular marrow. The result for a patient could be repeated rounds of ATG, and then a diagnosis of MDS, but that doesn't mean that ATG caused the MDS. In fact, since
ATG can improve precursor blood cell counts for MDS patients, ATG can make it easier to identify the MDS. I could be misinterpreting that study, since it refers to
developing a clonal disorder, as opposed to
being diagnosed with a clonal disorder, but I think it's worth asking your wife's doctor about your ATG concern.
By the way, the
AA&MDSIF FAQ has a short answer to the question "How do I decide between antithymocyte globulin (ATG) and bone marrow transplant for treatment of aplastic anemia?"