It Comes from Rabbits?! The ATG Experience – Part One

My Reading Readers Who Read,

Aplastic Anemia is a strange disease.  Doctors comprehend its basics, but like many autoimmune diseases there is a lot they just don’t know.  It amazes me that despite all the advances made in medical science, experts still don’t understand what causes some bodies to destroy themselves.  In most cases of AA, we know it’s a toxin that starts the reaction.  But why?  We don’t know.  We may never know.  If we knew the answer to that, we might understand Lupus, Crohn’s Disease, Pancreatitis, Eczema, Psoriasis, Rheumatoid arthritis, and the plethora of autoimmune diseases that are currently treated chronically because there is no cure.  Chances are you or someone you know lives with some kind of autoimmune disease.

Aplastic Anemia Blog - Immune System

The Immune System

The difference between those other autoimmune diseases and Aplastic Anemia is that AA has a cure.  This is a good thing, right?  Well, yes.  Technically speaking, it is.  However, unlike the many other diseases, which as I mentioned can be treated chronically, Severe Aplastic Anemia must be dealt with quickly and aggressively.  The nature of the disease is such that without major medical intervention, there would soon not be enough cells in the body to keep it functioning.  Without red blood cells the organs stop receiving the necessary amount of oxygen.  Without white blood cells the body can no longer fight disease and infection.  Without platelets the body can’t clot and any minor injuries including bumps or bruises could cause a hemorrhage.  These are the cold, hard facts of Aplastic Anemia.  Pretty, isn’t it!!??

I should point out that people can live on blood and platelet transfusions for some time.  White cells cannot be transfused, because they last only a few hours in the bloodstream and could cause fevers or infections.  The danger with constant transfusions is that eventually the body will create antibodies and resistance to the donated cells entering the bloodstream and kill them before they have a chance to populate and help the body.  Obviously, something more permanent must be done.

Aplastic Anemia Blog - Vials

Not my sister's blood.

As I mentioned in my second post, there are two treatment options for Aplastic Anemia.  The first is anti-thymocyte globulin (ATG), and the second is a stem cell transplant.  After my diagnosis, we decided to test my sister to see if she was my stem cell match.  A related donor is the best option for a transplant, as it reduces the chances of graft vs. host disease – a common complication with transplants.  Despite being my blood relative and sharing my rare blood type (AB+), there was only a 25% chance that she would match my tissue type.  She was sent the empty blood vials via Fed Ex in a Styrofoam box, marked bio-hazard.  She promptly had her blood drawn at her doctor’s and sent the vials back to the lab at Cedars-Sinai Medical Center.  Ten days later we got the results….no match.

If my sister had been my stem cell match, we would have moved forward right away with a transplant.  However, now that we had to begin searching the registry for an unrelated donor, we had time to decide whether or not to try ATG before moving to transplant.  After five weeks, three hospitalizations, and numerous doctor’s appointments, my physicians and I decided to attempt ATG.  I was to check into the hospital on Wednesday, March 2nd, and begin ATG treatment the following day.  However, my body had other ideas.  On Friday, February 25th, I spiked a high fever and was admitted to Cedars right away.  By the next day, the fever was under control and we decided to move forward with administering the drug therapy.

Coming soon…. It Comes from Rabbits?!  The ATG Experience – Part Two

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