Hi Tedsey, Trey, or anyone, anwhere who would if up for the challenge, me.
Sorry I have no idea if I am on the right path, but I am making a stab at it.
it is 9:30pm and I am a bit tired from staying up into the wee hours this morning, reading some of these articles and charts. I am 64 years and just a little slow at understanding all of this. Will have to get to bed early tonight, got to start out early tomorrow and bright eyed and busy tail.
I had a list of questions in my mind yesterday but they have left.
Anyhow I am looking at a chart by Call Me Lucky or maybe Scuba. I also have an article I have printed out by Trey called Genetics of CML overview.
To bad we don't all have a projector or something to look at while someone explain all of this, right?
OKK... at the top of the Chart I am looking at is the,
1) LT-HSC + Long Term Hematopietic Stem Cell, she would be the ancient mother stem cell, (don't know why I am calling her She.) Anyhow She LT-HSC is freshly created from the bone marrow, the # 1 stem cell in hierarchy, yes? At this point there is no CML, or any kind of blood cancer, she is a good stem cell? Correct?
2) She LT-HSC produces two daughters called ;
ST-HSC = Short Term Hematopoietic Stem Cell, right?
3. Now it would be these two daughter's of LT-HSC, the second generation, called the ST-HSC, that create an error of some kind, between her, St-HSC and the next level of MPP = Multipotent Projentiors. RIGHT?
Now I am looking at Trey article on Genetics. quote "To expand on the subject, these blood stem cells are divided into categories such as CD7, CD34, CD34+ CD38 -, etc. WHICH INDICATE DIFFERENT TYPES OF BLOOD STEM CELLS BASED ON WHAT IS ON THE CELL SURFACE CLUSTERS OF DIFFERENTIATION — CD)."" OK I am trying to figure the pecking order here and where the first error occurs. Are these compartments, CD7 Cd34 etc, of the LT-HSC and/OR THE ST-HSC or what???
While we are here at the top of genealogy of the stem cells between the 2nd and 3rd generation.
2. Are these compartments such as CD7, Cd34, etc where the transcript error occurs before going down to the next level MPP??? or does the error occur in the case of CML would be at the next level, CMP side = Common Myeloid Projenitors.
I hope I am making some sense I am trying to figure where or what level the transcript error occurs and if it is in these compartments, CD7 etc.
Also with the question above where does the PH+ begin?? Because first of all we have a transcript error that create the CML, then somewhere we have the start of PH+, right? Common sense would tell me the PH+ has to at least start at the CMP Common Myeloid Projenitors because the Ph+ effects the red cells, the platelets and the white cells or granulocytes.
Now at the point of CMP = common myeloid projenitors these guys/ladies are nucleus, meaning they have the 23 pair of Chromosomes. So I would be assuming that again the PH+ is somewhere here at the CMP level?
Now at the next level MEP (not sure what MEP stand for) The Erythorocytes, that makes the Red Blood Cells, and the Megakaryoctye that make the platelets. The red cells and platelets are no longer nucleus but the CML has affected them (as I had 2 million platelets at diagnosis). And the PH+ started at either the MPP or the CMP level, therefore the PH+ has effected the red cells, the platelets and of course the white cells (made of granulocytes basophil, neutrophil eosinophil) The white cells/granulocytes, which are nucleus, therefore they multiply and make copies with the PH+ BCR/ABL.
Next Very Important Question, it is at the level of either the CMP or down a level at MEP AND GMP that the TKI works??? Which ever level CMP OR MEP / GMP THE TKI never reach the transcript error at MPP OR ST-HSC WHICH EVER IT IS, because at this point I am not sure at what level these thing happen at.
Next very important question!!!!! At which level do mutations occur??? Are these mutations that doctors speak of on the PH+ like are we talking about the P210 breaking point, etc or another chromosome? Or are the doctors referring to mutations at the higher level of ST-HSC OR MPP??
I Think if I could understand the above it would answer a lot of my question about the TKI and decisions I need to make going forward. I mean really I have that sometimes when you or doc make a bad decision sometimes there is no fixing and a lot of needless suffering and consequence. Doctors after different theories, but I am the patient and I would like to undestand it enough to make some intelligent decsions.
Does this make any sense?