3 replies to this topic

[rich1403989321]

Hi all, can't tell you how helpful this board is for a newbie.  My base PCR Value is 95.  I'll have my one week followup on Friday after starting Gleevec last Thursday.  Should I expect a big drop from 95?

Thanks,

Rich

[Marnie]

Hey, Rich. . I'm assuming from your post that you have CML.  I would recommend putting your post on the Living With>CML strand.  That gets checked more regularly than the Newly Diagnosed.  You'll get tons of input from the folks on the CML site.  As you can see from the number of posts, we are the most active site.

In the early weeks, you will probably see some significant drops in your CBC numbers.  Is your doc planning another PCR test this soon?  That surprises me.  Typically, you will have a PCR test done every 3 months. 

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Good luck!  Looking forward to hearing from you on the forum.

Marnie

[CallMeLucky]

I would not expect to see any changes in PCR after one week.  PCR is really not a good test early in treatment, it is a much more sensitive test that becomes useful after you have been on treatment for a few months.  Early milestones look for a complete hematological response which means your blood counts go back to normal, using a Complete Blood Count (CBC) test.  This shows you are responding to the drugs and going in the right direction.  This is expected within first three months.  Your next milestone is cytogenetics which look at how many PH+ chromosomes you have.  The bone marrow cytogenetics will look at 20 cells under a microscope and see how many are leukemic.  You could also get a FISH test which usually looks at between 200 and 500 cells.  You get a ratio of leukemic to normal cells and you are in complete cytogenetic response when the FISH or bone marrow are negative.  This is expected within 12 months although more recent studies are suggesting the faster you can get to CCyR the better.  After that PCR becomes more relevant and ideally you get to a 3 log reduction on the international scale by 18 months.

After one week on Gleevec you should not expect anything, a drop in your White Blood Count would be nice.  If your doctor ran a PCR last week and is running another one this week, you may want to question that.  Other than generating some revenue for the lab, there would be no reasoning for running another PCR one week into treatment.  More than likely he will be running a CBC next week, which is to be expected in the early days.

[rich1403989321]

Lucky,

you were of course right.  Didn't even take the PCR test.  Did the CBC.  After one week on Gleevec a minor reduction of WBC as well as a reduction of RBC.  So the good news is a little lower WBC count but the bad news, possibly getting anemic.  You know, this whole CML thing pisses me off...I have every symptom but one...I still can't lose weight!  Take the pain away, let me lose 10 pounds!  Sorry, I tend to joke around.

PCR test in about 3-4 weeks, just the CBC and metobolic tests in the meantime. 

Thanks again to all on this forum, really helpful.

Rich