Here is a guide that many Oncs use for managing CML, especially when there are issues such as loss of response:
http://www.nccn.org/professionals/physician_gls/PDF/cml.pdf See page 12 for your issue of increasing PCR numbers. If you are only slightly positive then waiting for another PCR might be the right approach. But if you have gone from PCRU to a PCR that has increased more than 1 log (above approximately .01%) then both a bone marrow biopsy (BMB) and a Kinase Domain Mutation Test are a good idea. Zavie's points about T315i and losing valuable time are important. Since you are at the max dosage of Gleevec, increasing your Gleevec dosage is not an option. So your Onc is right that Sprycel is most likely the best course, but how does he really know? If you have T315i mutation, you would need to pursue other non-drug options, and speed would be important. Also, there could be chromosome changes that only a BMB would show. If it were me, I would press for the BMB and mutation test. Here is a link from one lab that performs Kinase Domain Mutation testing (there are several others): http://www.aruplab.com/Testing-Information/resources/TechnicalBulletins/BCR-ABL1%20Kinase%20Domain%20Mutation%20Jan%202007.pdf --~--~---------~--~----~------------~-------~--~----~ [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 -~----------~----~----~----~------~----~------~--~---
