We've been all the way to Oregon to look at this. Current thinking is that it is some other as yet unknown auto immune idea causing severe myleosuppresion. When she stops TKI for long enough, her counts begin to come up. When she stops long enough to move her counts up, PCR is already too far up.
There is a history of heart irregularities that they look at that prevents them from changing drugs, even to see if it changes her blood counts. They also don't believe it is worth all that just to get blood numbers on paper to match what they think is right. She does not get sick, has not had any form of fever or bad infection since having her counts monitored so closely, so they are less and less alarmed about it as time goes by. She wants to stay with what works, she fears the change will cause irreversible disaster, something they used to sorta preach but don't so much anymore. She has seen the other side and doesn't want to go there.
Quite frankly, the numbers on the blood draw are just good ideas, nothing in concrete for any doctors, so the oncs are glad they have succeeded in putting her in remission and want her to stay there no matter what her counts are.
For a year plus now she has had no treatment at all for low counts. ANC as high as 900, back down to 100. This draw at 600, an improvement over previous quarter, but accompanied by the smallest rise in PCR.
rct