--- In [EMAIL PROTECTED], rrockef1 <[EMAIL PROTECTED]> wrote:

> Hi Nanc.  If your mutations showed wild type, to what do they 
attribute your
> relative insensitivity to IM?  Drug efflux?  Suboptimal uptake?
> 
> Cheers,
> Richard R
_______________________

Hi Richard, 

I thought you were going to say I was a 'wild thing' and not a 'wild 
type'. 

Actually Dr. Druker has never thought I had a mutation, and neither 
did Dr. Talpaz when he saw me in Feb. 2003, before mutation testing 
was available....from looking at my response to IM. It is not a 
mutation pattern. We kind of did the mutation test just to confirm 
this. I had a small response to 400mg (from 100% down to 80%) and then 
a larger response to 800mg (fluctuating between 15% and 40%).....
but I have never lost my response. The variation I have up and down is 
within the margin of error of cyto testing. Make sense?

Dr. Druker says I have a primary resistance (or decreased 
sensitivity)to IM, and that the causes of this are not well 
understood. Also, those who never get a cyto response and stay at 100% 
ph+ but have stable disease are probably in this category. He 
mentioned possibilities like a pump that pushes IM out of the cell or 
out of the nucleus, etc. The expectation (or hope) is that when I am 
on a more potent drug, I will get a better response...and they are 
seeing some people who have never had a cyto response, getting a 
response with BMS.  

This is different than the acquired resistance that you get with 
mutations. Here, someone might be 23% ph+, then 3 or 6 months later up 
to 75% ph+.....this pattern looks more like a mutation...the response 
changed.  My response is stable, just not complete. 

Maui Nanc  









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