The new drugs are having tremendous success with so many patients so there
are still a lot of options and MDACC is one of the best places to be.
----- Original Message -----
Sent: Monday, December 27, 2004 4:14
PM
Subject: [CML] Houston, we have a
problem...cytos
I received my first set of cytos since relapsing.
The news is not great....
Looks like I will be back in Houston sooner than
expected.
> Dear
Mr. Tessler:
>
> I have attached the cytogenetics results
below:
>
> Ph+ clone
48,XY,+8,+8,t(9;22)(q34;q11.2)[11]
>
2 metaphases photographed/karyotyped
>
> Diploid male karyotype
46,XY[9]
>
2 metaphases photographed/karyotyped
>
> Although the number of
abnormal metaphases is less than has been the case
> before, there are
additional cytogenetic changes consistent with clonal
> evolution in
addition to the Philadalephia chromosome (i.e. clonal
> evoluation
consistent with accelerated phase). The options are to continue
> with
the combination as is (after all you only have been treated for 3
>
cycles), OR to try a different approach such with one of the newer
>
tyrosine
> kinase inhibitors (e.g. AMN107). Personally, I prefer the
latter. I have
> already put out my feelers with the research nurse of
the AMN protocol. If
> you wanted to consider this as well, we should
get you back earlier, like
> next week. Also you would have to be off
imatinib and any additional
> investigational agents. Let me know what
you think.
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