Thank you, Marlene. You are so informative about the disease.
My mother's age is another reason for the slow response, the hematologist said. It could be close to another 8-9 months or more or so before her bone marrow really heals (if it does). That's hard to believe. So, 1-2 years for the bone marrow to really heal from aplastic anemia is very true for slow responders. I couldn't believe this. In fact, some older woman took 2 years for her horse-atg to work. She was transfusion-dependent every week for two years for blood and platelets!! All of sudden, the atg worked. She went on to make a full recovery from aplastic anemia.
The hematologist also said that when neutrophils never come up at 6-9 months or so with no blood or platelet improvement, that's a sign that the horse-atg is probably not going to work, even in "very slow responders." There are exceptions, however, where slow responders have had no lines improve (blood, platelets and neutrophils) until after a year -- but it's rare. Knowing when to do a second treatment is tricky, however. How long do you wait? Who knows? With older people, it's best to ride it out, she implied. She went on to say that higher neutrophil stability is indicating that atg is working, but it doesn't prove it. She told us last week it looks like it is going to be a long waiting game for my mother, even if she gets another big rise in blood, or has her blood stabilize somewhat. So, she won't guarantee us anything, other than saying her higher neutrophils stability "points to" - but doesn't prove - a success.
By the way, she was really impressed with my mother's big jump in blood a month ago, 11 days after a transfusion (8.6 to 10.5), but she stole the joy away from us by saying she needed a second one for the first one to have any real meaning. LOL. Can't win.
As far as iron levels are concerned, they can be all over the place when people are getting regular blood transfusions. That is correct. There can be big fluctuations, which can make it difficult to know who needs iron overload treatment and for how long.
Health and happiness to all.