New Member
Posted 13 May 2012 - 08:59 AM
I am somewhat confused
Can some lay out or explain how much log reduction should occurred at what intervals of time that shows successful treatment?
I thought I heard my onc say three to four log at three months, did I hear him wrong or could it be my starting point was high?
Thanks,
Johnc
Advanced Member
Posted 13 May 2012 - 09:52 AM
That would be wrong. 3 log reduction is a major molecular response (MMR). Ideal time frame is within 18 months, but if you don't get there by 18 months it may not be that big an issue, just need to look at all factors to assess if you should stay with the treatment you are on or consider something else that may be more optimal. By 3 months you are looking for blood counts to return to normal.
Advanced Member
Posted 13 May 2012 - 12:26 PM
John,
These guidelines will tell you all you need to know at this point about response levels and time frames - pgs 40-46.
http://www.nccn.org/.../cml/index.html
Pat
Pat
"You can't change the direction of the wind but you can adjust your sails."
DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>
Advanced Member
Posted 13 May 2012 - 04:57 PM
John,
The gang is right. It amazes me how much more we know than most oncs! The goal at 3 months is to have normalized blood counts on a CBC (hematological response). And over the first 12-18 months of treatment, what is MOST important is to have a Complete Cytogenetic Response (CCyR), which is either a negative cytogenetics report from a marrow biopsy or a 0% FISH test result (zero Ph+ cells detected in a sample of 200-500 cells), although many reach that goal within the first year of treatment. The PCR log reductions are important, and although the NCCN guidelines don't state it explicitly, it's good to get to the -3.0 log reduction from baseline (Major Molecular Response) over the first 18 months. But the specialist I see has some CML patients who took several years to get to MMR and are doing just fine...
Hope this helps...
Dan - Atlanta, GA
CML CP Diagnosed March 2011
Gleevec 400mg
Advanced Member
Posted 13 May 2012 - 05:18 PM
Pat. . thanks for that link. I had not seen the patient guidelines book. I always carry a hard copy of the NCCN guidelines to my appointments, but the patient book is a great resource, as well.
Hope you are doing well. Only 7 more days until summer vacation. I think that I might survive. . .maybe. And then it's back to elementary school (our district is moving 6th graders back to elementary while they build a new 7-12 building. I am SO GLAD that I will be out of the current zoo. It has been a rough year.
Marnie
New Member
Posted 13 May 2012 - 07:57 PM
Callmelucky, hannibellemo,marnie, & Dan
Thanks for all your Responses!
Johnc
Advanced Member
Posted 14 May 2012 - 05:39 AM
I'd recommend the CML Pocket Card from the European Leukaemia Network - sets out all the response targets in a single frame so I find it easier to use than wading through the NCCN guidelines:
http://www.leukemia-...ecommendations/
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