My doctors believe I have Amegakoryoctic Thrombocepenia. For the last three months I have been taking 6 MG of Tacrolimus. It has not changed my Platelet count significantly. (29 to 47) They just did another bone Marrow biopsy and depending what they find this time they art thinking ATG as an out patient since I am in a area that does not have a high quality hospital use to dealing with ATG. My red cells are enlarged and I get winded very easily. What are your thoughts? John
Dear John, Acquired amegakaryocytic thrombocytopenia is a very rare disorder. There are no clear guidelines for treating this condition. But most of the people use immunosuppressive agents such as cyclosporine/ tacrolimus. If there is no response ATG is used. There are some case reports where Rituximab was used, and it gave good results. For me 47,000/CMM, is a good platelet count. It is count at which there is absolutely no bleeding risk. Hence, I would continue with tacrolimus as long as platelet counts remain over 20,000/CMM. I am eager to know the result of your second bone marrow test. As amegakaryocytic thrombocytopenia is a rare disorder. Are we missing something? I am also not comfortable giving ATG on out patient basis. It needs close observation and monitoring of patient. Please get your vitamin B 12 levels tested, if your RBC's are really large. With regards,