9 replies to this topic

[Lucas]

hey guys, i'm on a brazilian cml group and people ask me what's the % of cmlers who developed mutations over time. i read somewhere that it's around 10% of the patients. is it right? thanks in advance.

[Trey]

Probably about 15%.  In this study it was 18% of a large group:

 

http://cinjweb.umdnj...rcharticle1.pdf

[gerry]

Trey,

I'm confused is it people develop mutations over time or some become resistant to their TKI over time?

[Lucas]

this study is from 2003, with many patients from interferon era. most of mutations were found in patients who were 4 years from dx. i read another study - a nilotinib study - and find that 10% number, i don't know if it's correct, but i think 18% are much more than we saw in this and others group. thanks anyway, trey!

 

http://www.bloodjour...ent/121/18/3703

[rcase13]

Still scary to a newbie like me... I hate all these percentages... Mutations... Resistance... Ugh.

 

I am going to bury my head in the sand and repeat over and over. I am going to live, I am going to live...

[pammartin]

You are going to live. And you will come out of the sand. When you are ready. Till then use sunscreen, there is a lot of skin exposed to the elements.

[Marnie]

And watch out where you get the sand.

[Trey]

Trey,

I'm confused is it people develop mutations over time or some become resistant to their TKI over time?

Very few mutations occur after the two year point.  Most occur within the first year after diagnosis.  If a person can get through two years, they are usually safe.

 

Lucas,

You cannot compare stats for those who started on interferon vs TKI.  The interferon group had more issues of all types.  And regarding percentages, they are all over the map.  I provided a controlled study where mutations were measured and what was found, which was 18%.  Any other study would show another number, lower or higher.

[CallMeLucky]

A mutation, while it sounds scary doesn't have to be disaster, most of the mutations respond to a drug that is available.  Granted it puts you in a riskier scenario and reduces the number of choices you have, but realistically while 18% may develop a mutation, the impact of that 18% on overall survival is likely a very small percentage.

You will notice that today I am wearing my rationale hat, feel free to look back on some of my psychotic panics to see that I walk a fine line.

 

 

[Lucas]

Hey, trey. first, thanks for the response, but i post a study from 2012, i think, where the number of mutations was 10% (gleevec group) and 5% (tasigna group). the 18% study had a lot of patients from interferon era (the study is from 2003), just that. As you said the number can goes up and down if we take different studies.

 

you're right, lucky, most of mutations have no impact on survival and we have to be aware that resistance is multi factorial. good luck to you all (and to me)!