7 replies to this topic

[criscris]

Dx CML,

CML, Newly diagnosed 7 months ago.

Can anyone please tell me what these test resultS below mean? Does these results mean cured? No more Gleevec? Or do i have to go for another BMB?

I would greatly apprecaite anyones help in this matter. As my nurse has mailed the results to me and i still have not heard from my doctor on what this actually means.

AbnormalitiesCut off value (95%)               Results

t(9;22) BCR-ABL 1 fusion                          0%                               normal

Impression

t(9;22) BCR-ABL 1 fusion                                                              NEGATIVE

Comments

Interphase FISH analysis was performed with Vysis BCR/ABL 1 probes for t(9;22). Analysis of this sample was negative for the presence of the BCR/ABL 1 fusion.

FISH analysis of the pre-treatment bone marrow sample (12-2011) was positive for thr presence of the BCR/ABL1 fusion.

    

[Trey]

This was a FISH test, and the result was no leukemic cells found in the sample.  That is Complete Cytogenetic Response (CCyR).  The PCR is more sensitive than the FISh, so you should only have PCR tests from now on.  You do not need any more BMBs.  This is a very good result for under 9 months. 

[criscris]

Hi Trey,

Thank you for helping me to understand the test results. Dx of CML was made in Decemebr 2011 by blood work and confirmed by BMB in December, 2012.

Gleevec was started January 24, 2012, so therapy with the Gleevec has only been taken for 6 months. This latest blood test was taken on July 25, 2012, just 6 months after starting Gleevec.

The PCR from same date showed 68.24

Does these results mean almost cured?

I have been reading online that in some cases, therapy with gleevec is stoppe and no longer needed because gleevec can cure some patients.

What is the best response to have?

Thank you Trey.

[PhoenixPat]

No, chrischris, this does not mean "almost cured."

As Trey said, your results are good and indicate you have reached a Complete Cytogenetic Response (CCyR). This next step would be to reach a major molecular response or complete molecular response. If you achieve a complete complete molecular response, and you maintain it for a specific period of time, then you MAY be a candidate for a clinical trial to stop treatment under close monitoring.

If you are not familiar with the three responses for CML treatment this page will help you: http://www.lls.org/#...suringresponse/

[criscris]

Pat Elliot,

So this sounds like the Gleevec is working the way it should, and also with achieving CCyR after only starting Gleeveci 6 months ago, i assume is a pretty good result.

In reading the link you shared with me it said that CCyR is usually achieved/desired 12-18 months after treatment.

This is very encouraging! Thank you for helping me out to try and better understand these results. And thanks for sharing the link, it was very helpful.

Desired Response

People with CML respond to treatment in different ways. These are general guidelines for CML drug therapy. Your baseline results (your test levels at the time of diagnosis) can influence your response. But, your doctor will generally work with the following time frame as a guideline to achieve the desired response:

Time Frame	Desired Response
After 3 to 6 months of therapy	A complete hematologic response and some cytogenetic improvement
After 6 to 12 months of therapy	A partial cytogenetic response of two-thirds reduction in the number of Ph chromosomes in the marrow
After 12 to 18 months of therapy	A complete cytogenetic response and partial molecular response

[Trey]

You are doing well.  Treatment goals are best viewed as first achieving at least CCyR, since it is probably the most important treatment milestone, then moving on to MMR (3 log reduction by PCR) and then to an undetectable PCR.  CML treatment is a process, not an event.  So a cure is not the near term objective for now. 

[criscris]

Hi Trey,

Thank you for helping me to understand the treatment goals. Since we are newbies to all these medical words used for CML testing, i was not sure of what the differnece was between FISH and PCR.

So you think there is no more need for BMB?

Trey, I have been reading your blog and find it very interesting and very helpful.

Thanks again.

Cris

[Trey]

No real need for any more BMBs, but some Oncs want one at 1 year regardless, so don't be surprised if yours suggests one.