I was diagnosed with cml Nov 20l0 and have watched all you great people support each other. So now I am asking for your input. Recently had my third bone marrow biopsy in twelve months. Although, I don't understand all the technical terms of the report, I think the news is good. Fish results: Negative result for t(9;22) BCR/ABL1 Philadelphia translocation.. PCR results: BCR-ABL T(9;22) FUSION: 0.000 Now this is the part that has me concerned.....Bone Marrow, Decalcified Core Biopsy, Clot section cell block, aspirate smear and touch preparation morphology: Mildly hypercellular marrow with a mild increase in the trilinear hematopoietic cells present but showing appropriate maturation through mature forms with no dyspoiesis and no increase in bone marrow immaturity. This represents a change from the patient's prior marrow showing a normal to hypocellular marrow. So, my question is: Does this show a trend upward ? Which isn't good? Should I be celebrating with one of those chocolate martinis or be concerned? I am on Tasigna 300 mgs twice a day. Sorry this rambled on for so long. Best Regards Donna
Fish and PCR results with mild hypercellularity???
Posted 28 November 2011 - 01:00 PM
Posted 28 November 2011 - 02:04 PM
This question will likely be answered by Trey. From my perspective, knowing what I know, I would be mostly happy with this. First you are FISH negative and it appears PCR negative, so that is really awesome. I'm not sure what the possible causes of the hypercellularity are, I am interested to hear if Trey thinks this is one of those, maybe they caught your bone marrow in a production cycle where more cells are present. The fact they are saying that it is "mild" and that all the appropriate stages of maturation are present all sounds encouraging. I don't see any of the things we worry about like Blasts.
Overall I think this sounds pretty good.
Posted 28 November 2011 - 02:09 PM
As Lucky touched on, the hypercellularity and trilinear stem cells, with appropriate maturation, just means your internal machinery is hard at work making good cells
Posted 28 November 2011 - 05:36 PM
Hi Donna, welcome! This sounds like great news to me too - negative! I'm not going to have a full-on go at interpreting this, as there are others with much more knowledge. But it does say appropriate maturation, which to me sounds pretty good
Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).
Commenced monthly testing when MR4.0 lost during 2012.
2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)
2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)
2015: <0.01, <0.01, <0.01, 0.013
2014: PCRU, <0.01, <0.01, <0.01, <0.01
2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01
2012: <0.01, <0.01, 0.013, 0.032, 0.021
2011: 38.00, 12.00, 0.14
Posted 28 November 2011 - 06:12 PM
The negative FISH and PCR tell the important story. An undetectable PCR is hard to achieve in 12 months, so you have responded to drug therapy much better than most CML patients.
The other stuff only says that you have more blood cells in the marrow than before, when you previously had low to normal levels. Since the PCR is negative, these cells are more than 99.99% good cells. And the cells are behaving well by maturing properly (they are not "blast" cells). So there is no worry there. In fact, your marrow is returning to normal faster than for most people.
You are doing extremely well.
Posted 28 November 2011 - 06:34 PM
Thanks for responding to my question. I did forget one part. My onc said he was going to skip the next bmb which would be in 6 mos. That would leave me with having a CBC and a metabolic blood test to check liver etc. Also, GRF has gone from >59 to <59. I read that is the breaking point for a diagnosis of CKD. Any thoughts on these two issues.
Oh, what about the chocolate martini? Is it okay to have one? Thank you for your time and interest. Donna
Posted 28 November 2011 - 06:46 PM
I think you should have two chocolate martinis with those results.
Posted 28 November 2011 - 08:04 PM
I was waiting for somebody to give me the green light on that choc martini. Cheers!
Posted 28 November 2011 - 08:45 PM
The GFR only means something if it remains there for an extended period. The TKI drugs can cause these values to spike from time to time, so it may just be a temporary issue, which does not necessarily indicate actual kidney damage. But watch the longer term trend to be sure.
Drink the Chocartini if you wish. I guess it's a girlie thing. Phil and I will stick with Bushmills straight up, thank you. Goes great with FISH, especially PiCkeRel. Also goes great with zero FISH or zero PiCkeRel. Just a "mild hypercellularity" aftertaste is all.
Posted 28 November 2011 - 09:13 PM
Congratulations Donna and enjoy your well-deserved chocolate martini. I agree with Trey that they do seem to be more of a girl thing, but as there's no FISH and just a lightly stuffed marrow I think I'll have a pint of mild.
Posted 28 November 2011 - 09:48 PM
Phil & Trey,
It's taken a year but I have finally had my first laugh over CML. You two must stay up nights to come up with this dialogue. My best to both of you. Still laughing in Spokane-Donna
Posted 28 November 2011 - 10:30 PM
Welcome, stay with us you'll be laughing a lot more. Remember Laughter is the best medicine. Sincerely Billie
Posted 29 November 2011 - 06:03 AM
Phil & Trey,
It's taken a year but I have finally had my first laugh over CML.
My work here is done.
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