8 replies to this topic

[Lucas]

Hi everybody. I've just found out that i have two pH negative clones with trisomy in the 8 chromossome. I know this is commom and that other people here have the same issue. What did yours doctor told about this thing? Does it goes away? I'll start tasigna in two days. Thanks in advance

[Trey]

Trisomy 8 is the most often seen chromosome secondary mutation in CML besides the t(9;22) Philadelphia chromosome.  The TKI drugs apparently can cause trisomy 8, and when that is the case the trisomy 8 should disappear over time as the response deepens, generally after CCyR.  You have been on Gleevec, which does not cause trisomy 8 as often.  Sprycel seems to be the drug which more often causes this issue. 

 

If the trisomy 8 is in the leukemic cells, then that is the better case scenario.  When it is in the non-leukemic cells as in your case, the issue is less clear.  But there is nothing that can be done about it except to wait and see if it goes away, which it probably will.  You only have 10% trisomy 8, so that is not so worrisome.

[scuba]

Trey is correct (as much a I hate to admit it ...). Trisomy 8 in the non-leukemic cells is often induced by Sprycel more so than the other TKi's (all the more reason to get off these drugs when possible). There seems to be a correlation between Trisomy 8 in non-leukemic cells and myelosuppression. Over time it should go away, but who knows. Trisomy 8 in non-leukemic cells may or may not be benign. No one knows. In my case, I had 65% trisomy 8 in non-leukemic cells a year ago even though I was MMR at the time and am now PCRU. And I have myelosuppression (not severe, but does cause anemia) which does seem to be lessening. It seems the only down side to this is that I have to have annual bone marrow aspirations - next one in 3 months. I can't wait.

[Lucas]

Thanks trey and scuba. My doctors told me that it's nothing to worry much but there is some risk to develope MDS (do you know how much is this risk?) and that i will nerd to have bmas every 3 months. I do suffer with low counts but not much - 85k plts, 2k ANC and 13.5 HB. That doctor tried to put me in sprycel but my CML specialist wants to try tasigna first. If the trisomy were in leukemic cells thanks i tthink i would prever sprycel. Thanks everybody

[scuba]

Thanks trey and scuba. My doctors told me that it's nothing to worry much but there is some risk to develope MDS (do you know how much is this risk?) and that i will nerd to have bmas every 3 months. I do suffer with low counts but not much - 85k plts, 2k ANC and 13.5 HB. That doctor tried to put me in sprycel but my CML specialist wants to try tasigna first. If the trisomy were in leukemic cells thanks i tthink i would prever sprycel. Thanks everybody

 

Lucas - For what it is worth: http://www.ncbi.nlm....pubmed/19811560

 

According to the study I link above, there does not seem to be a correlation between +8 Trisomy and MDS. Perhaps your doctor is not familiar with the research. Also - Dr. Cortes has me taking  bone marrow aspirations once per year, not every 3 months. Your 3 month CBC's will alert them if a more frequent bone marrow is needed. 

[Lucas]

Thanks for the insight, scuba. I more relaxed now. started tasigna (no drug break) today and looking foward for great results

[Trey]

The trisomy 8 is not true MDS if it is drug induced.  Therefore it cannot cause MDS.  Some docs have misdiagnosed CML patients who develop trisomy 8 as also having MDS, but they are almost always wrong about that.

[Lucas]

My local doctor doesn't think it's MDS. she just pointed that we need to check my marrow more often. she wasn't really worried and told the maybe there's a little risk to develop MDS in the future, but the risk was low. I read sarah's history and was really awful the way she was misdiagnosed. Thanks again, trey and scuba. The insight was very helpful and reassuring. Scuba, how's your marrow now? 

[Lucas]

"We investigated chronic myelogenous leukemia (CML) patients who developed trisomy 8 abnormalities in Philadelphia-negative (Ph-) cells during imatinib mesylate treatment to evaluate the clinical outcome and laboratory features. Of the 470 CML patients, 1.5% (n = 7) developed trisomy 8 chromosomal abnormalities in Ph- cells. The median interval of the first trisomy 8 observation was 12 months. Our follow-up cytogenetic evaluations revealed that six of the patients demonstrated a complete or partial cytogenetic response and that all of the six patients revealed no dysplastic changes following a bone marrow examination. Moreover, the percentage of trisomy 8 in metaphase karyotyping has decreased in five of the seven subjects. In conclusion, these results suggest that the emergence of trisomy 8 in Ph- cells is transient and not related to therapy-related myelodysplasia or acute leukemia".

 

http://www.ncbi.nlm....pubmed/18983302