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increase in pcr anyone?


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#1 alexamay09

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Posted 22 August 2014 - 11:29 AM

Hi, am coming up for my 2 years since diagnosis and my latest pcr has gone from 0.14 to over 0.35. My consultant says she's not concerned as the previous was 0.59. Have others experienced similar? I am really worried. I had hoped to get to the magic 0.01 but that seems distant now. Im on 140mg dasatinib a day. I am praying its not a relapse. Thanks.

Alex

#2 Trey

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Posted 22 August 2014 - 01:54 PM

Given the variations in PCR, the results must be viewed as trends, not as single events.  But that is easier said than done, since we hang on each PCR for validation of our response to TKI therapy.  However, you are still well within CCyR and not far from MMR.  So there is no reason to suspect loss of response.  It could just be the "PCR plateau" which term I invented after seeing this occur many times here over the years.  This PCR plateau occurs at about the 12-24 month point when the TKI drugs are trying to kill off the higher level leukemic cells. 

 

If you wanted some reassurance, you could ask for a short cycle re-test of the PCR in a month or so.  That would be a reasonable approach.



#3 alexamay09

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Posted 22 August 2014 - 02:34 PM

Thankyou Trey. Brilliant advice as always. My doc wants me to wait till 30th october for next test but it's a long time :)

#4 Floa7

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Posted 22 August 2014 - 05:59 PM

Just got my PCR results today and there on the rise also.

6 months ago was 0.5% 

3 months ago was 0.9%

Today was 1.2%

The oncol Dr. left it up to me. I could switch to a different chemo pill or stay on Gleevec. She said other pills have different side effects and I am not having any side effects from Gleevec 

Gleevec is going generic next year, yeah I am running out of insurance too, I can get on medicare next year. Hitting the big 65....

I choose to stay on Gleevec and get checked in another 3 months.

I am in good health I only take a Gleevec pill and calcium + D pill/day


1 2012 CML detected Started Gleevec 400 mg

In nov 2014 my pcr started to rise by Feb I stopped Gleevec and went onto

2 2015 Tasigna 600 mg/day

I have been PCRU for 2 years and stopped Tasigna 4 7 2017

5 8 2017 results 0.008

5 30 2017 results 0.028 

6 30 2017 results 0.3, I have restarted the Tasigna because it went above 0.1 

 

My son

11 2011 CML detected Started Gleevec 400 mg

He went 2 1/2 years on gleevec and lost PCRU

Started Sprycel went PCRU for 2 years and stopped the Sprycel, went back for 3 month checkup and PCR was 8.0

He went back onto Sprycel and now is PCRU again

3 16 2017 results 0.008

6 1 2017 results 0.002


#5 alexamay09

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Posted 23 August 2014 - 03:55 AM

Thanks Floa7. Good luck. I am fortunate that in the UK I get the meds for free. It must be tough being in the US if you dont have loads of insurance.X

#6 Trey

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Posted 23 August 2014 - 08:57 AM

Floa,

 

Make sure you do not take the calcium at the same time as the Gleevec.  It inhibits absorption.

 

Either staying with Gleevec for another cycle or switching drugs is an acceptable approach for your situation.  If the next PCR is not a drop I would increase Gleevec dosage to 600mg or switch drugs.






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