6 replies to this topic

[Buzzm1]

Lymphocytosis Associated With Improved Survival in Dasatinib-treated Patients http://bit.ly/1Vx1UFI

 

Lymphocytosis, which occurred and persisted in many dasatinib-treated patients in all phases of chronic myeloid leukemia (CML), is associated with higher response rates, significantly longer response durations, and improved overall survival, a study published in the journal Cancer has shown.1

Because the proliferation of clonal cytotoxic T-cells or natural killer cells has been observed following treatment with dasatinib in small studies of patients with CML, researchers sought to evaluate the incidence of lymphocytosis and its association with response, survival, and side effects in these patients.

[Buzzm1]

TGF-alpha, IL-6 Levels Predict Responses and Outcomes in CML http://bit.ly/1Rerptt

 

Elevated levels of transforming growth factor-alpha (TGF-α) and interleukin-6 (IL-6) in patients with newly diagnosed chronic-phase chronic myeloid leukemia (CP-CML) were strongly predictive of subsequent failure to achieve molecular response, and of transition to blast crisis (BC-CML) and survival outcomes, according to a new study.

 

Previous studies have shown that the failure to achieve an early molecular response (EMR; defined as BCR-ABL1 ≤ 10% at 3 months) has poorer survival outcomes; EMR is also predictive of treatment outcomes on second-generation tyrosine kinase inhibitors (TKIs) such as nilotinib and dasatinib, suggesting that those with EMR failure may have intrinsic TKI resistance.

[Buzzm1]

Stem Cell Transplant in Chronic Myeloid Leukemia http://bit.ly/1Zq1yAW

[rcase13]

Did I read it correct that only 40% to 50% reach MR4.5? If so that is depressing.

[Buzzm1]

Did I read it correct that only 40% to 50% reach MR4.5? If so that is depressing.

You're referring to: "But the reality is that the percentage of patients that reach these sustained MR 4.5s, even with second-generation TKIs, is at best 40%, 50%. So, there's still a significant number of patients who don't quite make it to those criteria for treatment discontinuation, and that's where there's an interest in can we do something else to push them to that level. - See more at: http://www.onclive.c....Q2BAU6m2.dpuf"

 

That sounds more like a reference to the percentage of people who are able to successfully discontinue TKI's without relapse ... one of the problems is that there are any number of patients who have been PCRU for many years and they are still on full dosage; they haven't yet attempted to lower their dosage, let alone make an attempt to discontinue their TKI.  IMO, that's what needs to change ...  Earlier encouragement by Oncs to lower your dosage, and cease TKI's if at all possible.

[Trey]

These issues such as lymph counts, IL-6, TGF-a, etc cannot be isolated as causes since there are so many variables which make it difficult to determine whether these issues are causes or just random.  So these studies are only guesses about cause and effect.  

 

Regarding PCRU percentages, over the long term they are higher now that there are 5 TKI drugs available.  There has been no collection of such data.

[Buzzm1]

Increased Serum Creatinine Reversible Upon Imatinib Discontinuation http://bit.ly/22HDLBT

 

For the study, researchers retrospectively analyzed data from imatinib-treatment patients. The glomerular filtration rate, urinary clearance, and tubular secretion of creatinine of patients were compared with those of matched controls. Researchers also evaluated variations of serum creatinine before and during imatinib discontinuation and after imatinib resumption in patients enrolled in imatinib discontinuation studies.

 

In terms of reversibility, researchers observed a median decrease of nearly 18% in serum creatinine after imatinib cessation in 15 patients from imatinib discontinuation studies. The study demonstrated that when treatment was resumed in 6 patients, there was a median increase in serum creatinine of almost 19%.