I had been PCRU for 5 plus years. Two years ago I began creeping up slowly. Last February I lost MMR with a 0.2025 and 3 months later to 0.5023. At that time I got a second opinion and that lab returned a result of 0.3200. I increased Imantinib from 400 mg to 600 mg and had labs run 3 months later from 2 different labs. The lab that previously showed the highest reuslt showed a decrease back to MMR at 0.0425 and the other lab result showed 0.2015; both showing decreases. The most recent reports have been 0.3255 from the lab that had reported me back in MMR previously, while the other lab was relatively steady at 0.2205.
We requested a mutational analysis and it came back with the following explaination: unable to perform bcr domain analysis because bcr b3a2 transcritpt level too low.
What the heck am I to make of this? Considering that the test has a margin of error of 1/2 log is it conceiveable that I am still in MMR? How much of a variance should I allow between labs? Which should I believe? I actually talked with the doctor who was the chief pathologist at one of the labs and was told that the margin of error could actually be as high as 1 log. I am trending upward but how do we establish a threshold that clearly indicates a change in therapy. All other blood values are normal, cbc, differentials, and hepatic and kidney functions are all good.
One of the doctors is ready to switch without ruling out the t315I while the other doctor wants to wait, thinking that if it goes to 1.0 then I should change to dasatinib. What a tight rope this is to walk. I feel great and I am a very active 66 year old.