Sheila There is not alot of experience to draw from on this subject.
>From your description, you are in a Complete Cytogenetic Response (CCyR; FISH = 0). The PCR can be used to track disease levels when the FISH has reached its limit. Some studies have noted that people who reached a Major Molecular Response (MMR) by PCR (>3 log reduction) are very unlikely to experience a disease relapse. As a comparison, the Cytogenetic tests become negative around a 2.0 log reduction. Following up people who only achieved a CCyR but not a MMR showed that they did pretty good over the next few years but not quite as good as people who made the MMR level. However, this difference is very small and it may not even be clinically significant. I have heard doctors say that those patients stuck at the CCyR level need something changed (new drug like Sprycel/Tasigna or 800 mg Gleevec) and I have heard others basically say "if it ain't broke...". I have yet to see a study showing that there is benefit for any choice. I know the drug companies have tried to run these studies but they have not been completed. I recall a past Leukemia Society teleconference with Dr. Brian Druker. When asked his opinion about a case that is very similar to your description, he said stay with Gleevec. If you can take the 800 mgs, then keep it up. Keep up with the PCR. If the results show a trend of several tests increasing in CML levels (i.e less log reduction), then confirm with cytogenetics and then consider a change to a new drug. --~--~---------~--~----~------------~-------~--~----~ [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 -~----------~----~----~----~------~----~------~--~---
