Hi everyone - I'm new to this forum (usually post to the transplant forum). My son-in-law is six months past his SCT (sibling match) for ALL PH+. He has been doing really great but on the last round of tests (six month studies) he was told there was the presence of the philadelphia chromosome. He goes in again for retest as the doctors said it could be a false positive, but in the meantime he will be started on imatinib. Is anyone aware of what this test might be and the implications of it? Does this mean relapse? I know this is the CML forum, but a fried on the transplant board suggested I post here as there are people here that have PH+ experience. Hope to hear from you!
Six months post SCT testing revealed presence of philadelphia chromosome...
Posted 05 May 2012 - 10:32 PM
Well, I hope it is an error in detection. If there is an relapse there is an procedure strategy for managing relapse, - donor leukocyte infusion, might eliminate the need for a second BMT in some patients.
Hope everything goes well and keep finger cross... may the good result prevail...
Posted 05 May 2012 - 10:45 PM
It would be a PCR test. If it shows Ph+ it is most likely relapse, sorry to say. The higher the positivity of the PCR, the more likely it is relapse. That happens more often with sibling matches due to less Graft vs Leukemia effect. But a re-test will be done to ensure it was an accurate test. I would prefer to see the patient take Sprycel rather than Gleevec (Imatinib). Hope all goes well.
Posted 06 May 2012 - 02:51 PM
Thanks for the response. He goes in on Monday for another test and will be started on imatinib at that time. For some reason I don't think the transplant doctors have actually used the words "relapse". I do know that his brother was able to donate extra marrow and that something was saved "just in case", but I'm not sure what that was either. Maybe for a leukocyte infusion. I just sure hope the next test comes back ok.
Posted 06 May 2012 - 02:55 PM
Well, that' pretty much where my train of thought was going. It just seems so soon! He does have GVHD of his skin, so I was hoping that would have produced the graft versus host effect. But then again, I've read that this PH+ thing is pretty strong. I'm not sure why the doctors suggested imatinib over Sprycel. He was part of a clinical trial at NIH for his transplant and is still seen there. He's just turned 36, and before this was so healthy; served three tours in Iraq and Afghanistan and then bam! I'll post later in the week when he has his second blood results back, and after he talks with his team on Monday. Thanks so much for responding.
Posted 06 May 2012 - 05:43 PM
They may try a donor leukocyte infusion (DLI) from his brother to try to enhance the Graft vs Leukemia Effect. That can sometimes work, or maybe only help to some lesser degree along with the Gleevec (Imatinib). If that does not work, then a second BMT from an unrelated donor would need to be discussed.
Here are a couple additional resources:
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