Wow, I just got word that my latest peripheral blood FISH and PCR were both negative. This is after 12 months on Gleevec 400mg. I am very thankful (and fortunate) that Gleevec has been able to get my CML under control quickly.
A few questions for the group as I put this into context:
- I'd like to understand the sensitivity of Emory Winship's peripheral blood (PB) PCR test. They run the test on-site, so I'm assuming that the sample doesn't degrade much before they initiate the test. In addition, they measure log reduction against some standard baseline, although I'm still not quite sure where they get this baseline. It states something like "baseline is an average ratio for chronic phase CML patients at diagnosis". I was +0.50 log increase from Emory's baseline at diagnosis (through BMB/A). What is the best way to ask the PCR testing sensitivity question, so I can know exactly what CMR means for my case? Ask for the max log reduction from baseline that can be detected? Or is it more appropriate to ask for the smallest ratio that it can detect (e.g., 10/1,000,000)? And given the latest and greatest equipment around today, what should I expect? Thanks for your feedback.
- For my case, the CML specialist that I'm seeing does not plan to do a BMB unless there's a specific reason for it (loss of response, etc.), so all of my tests post-dx have been through peripheral blood. I've been CCyR for > 6 months through PB and now achieved Emory's version of CMR at 12 months. I was reluctant about this at first, but I've grown more comfortable ... and let's face it, BMBs stink. But I know other CML specialists feel strongly about doing marrow level analysis over the first year or two, even if the patient appears to be responding optimally through PB monitoring techniques. As fellow patients, I'm curious what your opinions are here?
Thanks for any feedback!