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hallo amrk
first let me thank u about the great job you are
doing for all of us. i cant emphasize how important it is.
i am already sumarizing what you wrote for all of
our israeli cml support group patients, and i wouldnt be able to do it without
your emails (and ofcourse cheril-ann)
about hydrea i wanted to add that there is a small
number of patients who respond cytogeneticly to treatment with hydrea. in our
israeli group we have a patient who went from 100 % ph+ to almost 0 % only with
hydrea. i know its uncommon but it does exsist and i am sure other patients
respond at least partially.
shalom
giora
----- Original Message -----
Sent: Sunday, December 05, 2004 9:54
PM
Subject: [CML] Re: Novel Agents in
Leukemia - Part I - @ ASH - Mark
Hi Tracey,
Yes, this is an interesting point
that I hadn't thought about until
Richard's post. This is my take on
it: Hydrea treatment will reduce
the absolute leukemic tumor load so
any discussions of total load
reduction should take Hydrea into
account. When discussing bcr-
abl/abl reductions there will likely be
no change in the ratio from
Hydrea. So from this context, hematologic
responses from Hydrea
should probably not be used. So bottom line we
really have two
distinct ways to measure reductions: absolute (total tumor
load) and
relative (ratio of bad to good). Most discussions focus on
the
latter (relative). But this thread serves as a reminder that
when we
switch gears and start to discuss reduction in overall tumor load
that reductions from Hydrea also must be taken into account.
It would also be interesting to see if PCRs are unchanged during
Hydrea treatment. After thinking about it more, I assume that they
are not changed but it would be nice to see real data. I should also
mention that this is all speculation on my part and that I would love
to hear what others think about it.
Well I'm off to ASH.
Cheers to all,
Mark
--- In [EMAIL PROTECTED], "traceyincanada"
<[EMAIL PROTECTED]>
wrote:
>
> Hi Mark,
>
> Thanks for taking the time to share with us your notes on ASH.
You
> bring up an interesting point that I've also thought of
often.
>
> Like you, I took Hydrea for a month before
starting Gleevec and in
> that month, my WBC normalized. I really
wish someone would have
> thought to do a PCR on diagnosis so that I
could have a more
> accurate target of what I've achived but I guess I
can't cry over
> spilt milk.
>
> In any case, what I find
confounding is that while we would assume
> that plenty of phillies are
being killed during Hydrea treatment,
it
> is also known that good
cells are also being eliminated with Hydrea
> so how could we know in
what proportion are the good and the bad
> being targeted?
Therefore, without an official PCR number, I don't
> know if we can
assume any type of log reduction with Hydrea alone.
>
>
Here's another thought that occured to me: for someone who started
>
out with a very heavy leukemic load and achived the famous 3 log
>
reduction, we know this fairs well. Now how about the person who
> started out with a very small leukemic load (because their disease
> was caught so early) and only achived a 1 or 2 log reduction from
> baseline. The end leukemic load in the second person may infact
be
> smaller than the first yet the reduction wasn't as impressive so
how
> would that correspond with PFS stats? I'm just thinking out
loud
> here. There may be a simple answer that I haven't thought
of or
> there may not be an answer at all.
>
> In any
case, thanks again for your time and please continue to
share
>
with us as much as you can.
>
> Take care,
> Tracey
>
> --- In [EMAIL PROTECTED], "mpetersen123" <[EMAIL PROTECTED]>
wrote:
> >
> >
> > Hi Richard,
>
>> You also brought up an interesting point about the log reduction
> due
> > to simply gaining a hematalogic response. We
tend to think along
> the
> > lines of IM-only therapy when
discussing log reductions but many
> > patients are initially
treated with Hydrea. In my case for
> example,
> > I
had a full log reduction hematologically just due to hydrea
> alone.
> > This implies that newly diagnosed patients should have their PCR
> test
> > performed at initial diagnosis rather than at
initial treatment
> for
> >
Gleevec.
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