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PCR testing frequency - after 1st year

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#1 sdl722


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Posted 22 June 2012 - 08:56 AM

Hi all,

Is there a recommended frequency with which one should get PCR testing done after the first year of treatment? 

I was diagnosed in April 2011 and have been on 800mg daily of Tasigna.  I am on a research protocol with MD Anderson so for the first year I had monthly blood tests and quarterly bone marrow aspirations and PCR tests.  At 3 months I had achieved CCyR and have maintained that (all confirmed by the aspiration).  In April at the one year mark my PCR was down to 1.31% on MD Anderson scale (at diagnosis it was over 100%).  My PCR number has trended down at every test. 

Now that I am in my second year of treatment I move to 3 month blood tests and 6 months aspirations.  I have my next blood draw in a few weeks and according to the research nurse, she said I wouldn't have a PCR test done...just the CBC and CMP.  My next PCR would be in October which would be 6 months since the last one. 

What is everyone's thoughts on waiting 6 months for my next PCR?  The NCCN guidelines don't really discuss frequency of PCR so I wasn't sure if I should push for the PCR done at 15 months or wait until October.

Thanks everyone!


#2 Trey


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Posted 22 June 2012 - 11:58 AM

It is not simply the amount of time since diagnosis but more about the depth and stability of response to drug therapy which determines testing schedules.  Even so, there is no firm schedule.  NCCN Guidelines say that after CCyR the PCR should be done every 3 - 6 months, so there is nothing wrong with 4 month or 5 month schedules.  Although some Oncs will extend the PCR schedule to 6 months after CCyR, I would personally prefer to stick with a 3 month PCR schedule until either MMR (3 log reduction) or after having been in a very stable CCyR for an extended period of time (maybe minimum 6 months).  To me it is a key point that until long term stability is achieved, the PCR should be on a schedule shorter than 6 months.  And remember that mutation based drug resistance is most likely to occur in the first two years after diagnosis, so a more conservative schedule during the first two years is advisable.

#3 sdl722


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Posted 23 June 2012 - 02:37 PM

Thanks Trey.

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