Re: Drug therapy - deaths?

From: Becca- rwalker@geo.arizona.edu
Date: 12/19/2003
Time: 7:48:14 PM
Remote Name: 172.155.244.200

Comments

Hi Sue, I did some internet research, and from what I read, it's not the drugs themselves that are responsible for deaths, it's the infections from a low white count that pose the threat. I did not read about many instances of death following ATG in general, though. Overall, it seems significantly safer than a BMT.

One relevant point is that patients seem to respond better to the ATG and are less susceptible to infections immediately post-ATG if their neutrophil count is high (well, as high as you could expect for someone with aplastic anemia, but you know what I mean) when treatment begins. If your son responds well to white cell growth factors, it might be something to talk to your doctor about so that he had lots of neutrophils preceding the ATG. (If you're not familiar with these, they include Neupogen and Neulasta--and just as a sidenote, you only need Neulasta every 10-14 days, while Neupogen has to be administered more frequently. My white count was 1.4 a couple days ago, I had a blast of Neulasta, and today my white count was 4.8 today with 80% neutrophils. So if it works, it really works!)

Also, has anyone told you about neutropenic precautions? The most important precautions that you can take are: (1) frequent handwashing by everyone, including patient (2) no one should touch the patient's face. The patient should avoid touching his/her face (especially rubbing eyes, touching nose, and touching mouth) and should only do so immediately after washing his/her hands.

Quick update on my situation: my only brother turned out not to be a match, so I'm starting the ATG on New Years Eve. I'm still feeling totally normal physically, so hopefully that will continue. If anyone had asked me a year ago how I was going to spend my 23rd New Years, I don't think that my answer would have been, "Having horse serum infused into my chest."

If anyone has any more information on ATG- associated mortality or can confirm/deny what I've posted, I know that both Sue and I would appreciate it! Merry Christmas!

-Becca

PS- Sue, I totally agree with what you said about the statistics; whatever they are, you just want yourself or your loved one to wind up in that "good" column! :)