Dane,
 
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.
 
Rob
 
----- Original Message -----
From: Dane T.
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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