We have been taught that TKI's do not affect Leukemic Stem Cells - the origin of our disease.
But this is not correct - TKI's do impact LSC's.
TKI's can, in fact, eradicate LSC's. I have suspected for some time that cure is possible if a TKI is taken long enough to allow the LSC population to die out. As LSC's divide, they get killed - and the population of the bone marrow steadily reverts to a normal LSC population. As the article above points out, the starting load of LSC's can be prognostic. But I don't know of any test that currently measures LSC burden at diagnosis so we know from where we are starting?
I believe the key to potential cure using TKI's alone is to find ways to encourage LSC's to divide (blood draws?). As they do so, they are wiped out and eventually (according to population dynamic computer models) extinguished. Apparently for those who reach PCRU within 18 months and remain so for another 24 months, LSC extinction can and does occur (STIM study: http://www.ncbi.nlm....ubmed/20965785)
Susan: You are cured. Lowering your Gleevec dose will increase your quality of life. Taking Gleevec gives you peace of mind I fully understand and appreciate. But there are no more LSC's in your body. They have long been extinguished. You too Trey. Congratulations to you both.
My LSC's are more difficult to eradicate, I can't get below detection let alone maintain it there on just 20mg Sprycel. I need a stronger dose I believe to continue to put downward pressure on the dividing LSC's.