Hello Brenda,
You are absolutely right, 0% blasts is a good thing, and defintely the first thing we try to achieve. However, as I mentioned in my post to Annette and Mark Petersen mentioned here last week I think, the Sokal scoring system is still quite a relevant and useful tool in helping your doctor to determine the phase of CML. The sokal scoring system looks at various things such as WBC counts at Dx, size of Spleen etc. At about three months (or sooner) into treatment with Gleevec (or IM - which stand for Imatinib Mesylate and takes much less time to type) we look for some type of hematological and cytogentic response. By Three months you should have achieved a hematological response, meaning that all your counts on your CBC report are within the normal ranges, platelets, basophils, neutrophils, WBC's, sometimes the Hemoglobin will be a bit lower than normal, but that is "normal" for people on Gleevec. A cytogentic response will show the reduction of Ph+ cells and this reduction is monitored using a FISH test - Flourescent in-situ Hybridization. This test can be done on peripheral blood or marrow aspirate. Usually in the first year, most doctors will do this test on aspirate. At 6 months it is not too un-realistic to be very close to zero on your FISH test. However, if you are not, do not worry, some patients may take up to a year or more. However, after being at ASH I can tell you that the objective is to get people to CCR and PCRU sooner than later and I think this is a very smart approach. We have learned that even when we are CCR there could still be 1 billion leukemic cells in our body. My moto is get rid of them before they can cause us any harm. However, another new trend is to take a quantitative PCR at dx so that log reductions can be monitored. By six months you should be close to a 2 log reduction if not 3 log reduction. It is very important to continue to monitor the QPCR results every three months after that, if all is going well and sooner if not, so that if there is a change in the residual disease level your doctor can intervene and put you onto another course of treatment without causing too much harm. Hope this helps, Welcome to our club, I can think of worse things in life than joing this group. We have much to be hopeful for. Cheers, Cheryl-Anne "Brenda Morelli" <[EMAIL PROTECTED]> wrote: > > Nan, > All I can tell you is in my last conversation with my onc what > I 'THINK' I understood is that he wants the blasts at 0%, which would > be a better indicator for longer remission and less chance for a > mutation to occur. However, I'm only 6 mth into this disease so I > could have misunderstood what he was saying. I go back in April for > another bmb/bma and I plan to probe him a little more. > > I welcome any veterans in the group to jump in and give their > thoughts. Am I way off? Besides blast % helping to determine what > phase of CML your in what else do they help measure/track? > Brenda > > > --- In [email protected], "nanny_net2000" > <[EMAIL PROTECTED]> wrote: > > > > Hi Cheryl Anne and Brenda > > Not sure I am understanding this at all, so forgive me if I have > > read it completely incorrectly. > > Rich is 100% PH+ since losing response to Glivec in May 2004. > > Discovered he has M244V P Loop Mutation, yet his blasts are only > 1%. > > Figures still have him in chronic phase, but consultant concerned > he > > was on verge of accelerated phase due to the grouping of the > blasts, > > as opposed to numbers. Currently on Hydrea and awaiting BMS in > > London, UK. > > Can you explain this article any further ? Hope I am not being > > dense. > > Love to you both > > Annette > > > > > > --- In [email protected], "Brenda Morelli" <[EMAIL PROTECTED]> wrote: > > > > > > Thanks Cheryl Anne, > > > This helps me understand why my onc was only semi happy about my > > > results, though I was 0 PH+ and PCR at .4%, my myloid blasts had > > only > > > dropped from 3% to 2% after 6 mths. That's what he wanted to see > > at > > > 0%, he had said that once blasts are at zero there is longer > > > remission hold AND less chance of mutation. > > > Brenda > > > > > > > > > --- In [email protected], "Cheryl-Anne Simoneau" > > > <[EMAIL PROTECTED]> wrote: > > > > Blast count and cytogenetics correlate and are useful > parameters > > > for the > > > > evaluation of different phases in chronic myeloid leukemia. > > > > > > > > Bacher U, Kern W, Schnittger S, Hiddemann W, Schoch C, > Haferlach > > T. > > > > > > > > Staging of chronic myeloid leukemia (CML) phases is based on > > > > cytomorphological criteria that vary considerably between > > different > > > staging > > > > systems. Thus, staging of CML is heterogeneous and causes > > problems > > > with > > > > respect to the comparison of therapeutical strategies and > > clinical > > > outcome. > > > > We evaluated 59 patients with CML in different stages of the > > > disease. In > > > > order to define which cytomorphological parameters correlate > with > > > > cytogenetics we investigated cytomorphology and cytogenetics in > > > parallel in > > > > all cases. As a result, bone marrow blast count demonstrated a > > > highly > > > > significant correlation with the respective cytogenetic results > > of > > > the > > > > patients and was clearly linked to the frequency and complexity > > of > > > clonal > > > > evolution. We therefore propose to focus staging systems of CML > > on > > > the > > > > correlation of the percentage of bone marrow blasts and the > > > cytogenetic > > > > results. ------------------------ Yahoo! Groups Sponsor --------------------~--> Give the gift of life to a sick child. Support St. Jude Children's Research Hospital's 'Thanks & Giving.' http://us.click.yahoo.com/3iazvD/6WnJAA/xGEGAA/8zSolB/TM --------------------------------------------------------------------~-> New! 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