2 replies to this topic

[hippychic]

Hi all,

 

I was diagnosed at the end of August 2014 with CML.

 

I have monthly labs drawn for CBC and the Diff, along with the BMP, Liver function Panel, and BCR-ABL every three months. I've had only one Bone Marrow Biopsy done back at the beginning.

 

This week, I had my regular Onc appt, and had my monthly labs drawn the day before. Everything was pretty much normal and in range except for the MPV (which is always low) and the MONOS %, AUTO, which is also generally low.

 

My Onc said that I needed to get a BCR-ABL and if it had lowered, then we would do the Bone Marrow Biopsy. Yesterday, she got the results back and said it was a bit higher this time and we would redo the test in a month. She just sent me my numbers, so is this normal ,at a year, to increase or is it something I should be concerned about?

Here's the results: ( I hope I'm typing this right as I can't get the info to paste here)

 

 08/26/2013...134.972 (IS)

 12/11/2013.....0.504

 01/13/2014.....0.100

 04/16/2014.....0.039

 09/05/2014.....0.144

 

Each date shows ABL1, BRL TRNL MIN

and ABL1, BRL TRNL MAJ Detected

 

I just can't seem to understand this test no matter what I read..

 

Thanks so much for all your help,

Mel

 

 

[CallMeLucky]

PCR can jump around so I wouldn't get overly concerned just yet. It is a 1 log increase and by technical terms a loss of MMR (you're still close enough to MMR not to be in any trouble). The question here is the increase and if it is in fact accurate. Repeat the test and see what it shows, if it goes back down then variability in test. If it confirms the increase they should do BMB and mutation analysis. Often a drug change can get you back on track. Also recognize that it could have been the prior test that was inaccurately low and you are actually flat.

Hang in there and see what repeat test shows.

Good luck.

[Trey]

You are still approximately MMR so all is well.  PCR variations occur due to a variety of reasons, including sample freshness, lab variations, etc.  Increases regularly happen at those low levels, and the one year point is often a plateau in PCR results, then downward progress is resumed later. 

 

The stuff you listed under the numbers don't mean anything, just lab verbiage.

 

There is no reason for a BMB at those low PCR levels.  Nothing would be found.  A rise in PCR, even if it is about a log increase, should not trigger a BMB unless CCyR is lost (approx 1.0% PCR), and you are still almost a log below that.  So your Onc should remain calm and just order a PCR re-test in a month or so as you said she would.  If your next PCR rises significantly to a loss of CCyR (not highly likely, but also not impossible) then a drug change is needed and a BMB would also be a reasonable idea.