Dear Steve, No Phiadelphia chromosome at 4 months is a great result, warm congratulations to Vanessa. The PCR may remain positive in some Gleevec patients, my husband has been on Gleevec for 4.5 years and his PCR is still positive, this just means that disease is present in low amounts. What you should now do is look at the PCR numbers. Are you doing quantitative PCR? This will give a number for the disease load and if this gets lower and lower with time, this is what the doctors are looking for.
Vanessa's counts seem to be dropping. Do you know what her neutrophil percentage is? Doctors look at the absolute neutrophil count and if this goes below 1000, some doctors stop Gleevec. And yes, doctors do give white cell boosters, they usually do this with the Gleevec,. The boosters are given to enable the patient to continue on 400mg a day. The boosters up the white cell count and then there is no need to lower the dose. There is a great article written by Dr. Brian Druker, called 'Practical Management of CML patients on Gleevec' and he basically outlines how doctors should treat low counts. If you wish, I can send you the article and you can show to your doctor. Dr. Druker says that if the absolute neutrophil count goes below 1000, to hold the Gleevec and allow the counts to come up again. Then he says to reintroduce 400mg Gleevec and if again the counts crash, only then go to 300mg a day. This rule, of course, may vary between doctors but if Vanessa is taking the white cell boosters, would that not keep her absolute neutrophil count normal and then why is there a need to lower the dose so soon? Would it not be better to see what the boosters do, 400mg is the standard dose in chronic phase. Absolute neutrophil count is calculated by multiplying WBC with the neutrophil percentage. Is this value very below 1000? Best Wishes, Anjana caregiver to Roy --~--~---------~--~----~------------~-------~--~----~ [CMLHope] A support group of http://cmlhope.com ------------------------------------------------- You received this message because you are subscribed to the Google Groups "CMLHope" group. To post to this group, send email to [email protected] To unsubscribe from this group, send email to [EMAIL PROTECTED] For more options, visit this group at http://groups.google.com/group/CMLHope -~----------~----~----~----~------~----~------~--~---
