Hi Annette,

In the case of your husband Richard, 1% blasts is quite small.  In 
fact most of us have at least 1% blast at Dx, and most of us are 
100% Ph+ at Dx as well.  I think the bigger concern is the P loop 
mutation, but we know the BMS drug has shown effectiveness against 
this particular type of mutation.  I would be inclined to ask the Dr 
what he means by the "grouping of the blasts".  That isn't 
terminology I have heard before. 

The points that I got from this abstract, and I will probably get 
the full article later this week, maybe tomorrow, is that it looks 
at the number of blasts and the cytogenetics instead of just relying 
on the sokal score system.  I posted this abstract because I found 
that this was in contrast to what was stated at ASH.  At ASH we 
heard that the sokal scoring system was still quite relevant as a 
good guide for staging the phase of CML.  

I'll be as excited as the rest of us to read the rest of this paper 
to see if it sheds anymore light on the situation for us.

Hope this helps,

Cheers,
Cheryl-Anne
<[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.





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