4 replies to this topic

[Sneezy12]

An interesting article. Frankhttp://www.ntkinstit...t_uids=22517301

[scuba]

http://www.haematolo...t/95/6/900.full

"Here, we argue that LSC should not be considered the main target for CML eradication. Instead, and in accord with the fact that CML is LSC-derived but progenitor cell driven,20 we show how and why progenitor cells, not LSC, are the major cause of problems related to CML. "

"Importantly, the tyrosine kinase inhibitor need not be taken for the rest of the patient's life (Figure 5) since it can cure CML.11"

just another example of "conflict" in CML research where no one really knows what is occurring in the bone marrow regarding these cells. The stochastic model described does comport with observed data very well (of course tweaking of coefficients in the model will do that!). If the model dynamics can be believed - then the main conclusion is that Imatinib therapy alone can cure CML though it does take years. In Trey and Susan's case, they do seem to be poster children for exactly the dynamics observed in this model. Taking Gleevec for the rest of ones life when in PCRu for years and years is almost certainly - not necessary. They are, in fact, cured. The progenitor Leukemic cell population is long extinguished and the LSC originating cell was probably gone by the time they were diagnosed (that is the truly interesting part of the study): The LSC cell pops in ... creates a mess and then leaves ... leaving the mess behind.

As more people stop therapy after PCRu for an extended time - the population of people who do not relapse will increase and provide the clinical evidence needed to support the model's conclusions. .. or not. Only time will tell. In the mean time - Susan61 - you are free of the disease - and if you want to be free of Gleevec's side affects, it may be time to set the bottle aside. I know...I know... it's o.k. to keep taking it. I understand. But I can't wait for the clock to start. Makes me want to increase my Sprycel dose just to speed this process up!

Trey - I look forward to your response. This is an interesting paper and worthy of your considered thought.

[Trey]

First, there is no connection between the article Frank posted and the one you posted.  Just to be clear that Frank's article is unrelated to your comments.

Otherwise, we have previously discussed the article you posted.  It was written by a math geek who uses only virtual patients (so no real patient data) and makes some odd assumptions at the beginning.  As you can read in the link below, I was, and remain, underwhelmed by the article.

http://community.lls...e/118627#118627

[scuba]

Thanks - Trey - I thought I saw this before.

Never mind ...

[valiantchong]

This report is nothing new, has no real value and only on the observations. It is not surprising that TKIs has effect on the CD34+ PH+ progenitor stem cells and other pH+ LSC cells in the blood. Nothing new... and it does not explain why on some patients is more effective than others... and there is no conclusion that is of usefull on this observation. It also does not proof that depletion of CD34+ pH+ cells equate to cure.....