I was wondering if anybody here was missing chromosome 7? I've been on Gleevec for a year now. My doc told me that I'm missing it and another doctor now wants me to have a marrow transplant somewhat soon? Anyone else?
Posted 16 July 2012 - 07:04 AM
This is how I understand my CM: and chromosomes:
I have not heard of that before. Usually with CML it is Chromosome 9 and 22 that form a union to cause the Philadelphia Positive Chromosome (PH+) ; it is a transgression of the two; you still have 9 and 22 however a little piece of each seperated and formed a union. The PH+ can be dissolved but the union is still present; that is where the Gleevec comes in. A targeted therapy to "target" the messaging system. LIke anything, if unsure thta your doctor has not answered your questions or you may not fully understand him/her, then I would get a second opinion.
Hope this helps
Posted 16 July 2012 - 12:35 PM
Secondary chromosome mutations can occur in CML. The most common are Monosomy 7 (loss of one of the two chromosomes #7) and Trisomy 8 (having a third chromosome #8). These can come and go, so it could disappear on its own. If this is the only reason for the one Onc saying a transplant is needed, then that is not accurate. There would need to be other evidence of disease advancement or loss of response by drug therapy.
If the Monosomy 7 is in the normal cells (the non-leukemic cells) then that is less of an issue than if the Monosomy 7 is in the leukemic cells. Same with Trisomy 8.
So you should ask: 1) Is the Monosomy 7 in the leukemic or non-leukemic cells? 2) Is there any other evidence that the Gleevec is not working? 3) Also discuss changing drugs.
The Monosomy 7 should be monitored in future blood tests. You may also want to have the tests more often.
Posted 16 July 2012 - 02:41 PM
I have been battling Monosomy 7 as well for the past 1 1/2 years, it comes and goes in the non-leukemia cells. Do you know what the breakpoint is, it does make a difference for the risk factors if it's an intestinal deletion vs. a complete deletion. Also, the breakpoints itself tends to matter. You should see something like:
Two of twenty metaphase cells examined were abnormal, with an apparentinterstitial deletion of the chromosome 7 long arm at band 7q22.
It doesn't mean a transplant is required as Trey points out, it all depends on how you are responding to the TKI's. This is something you definately want an experts opinion on, as it's not as common. I was told, that it does have some risk to develop MDS, but it all was dependent on how your numbers were. Most often than not, it's transient, and as my doctor said "go back to worrying about other things".
Hans , Woodinville WA
Zavie Club #1303
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