3 replies to this topic

[Red Cross Kirk]

https://communityvie...ve-leukemia-cml

 

Below is a quote from the above article on the new forum.  Am I reading this wrong?  It looks like they're saying the rate of CHR is lower than the rate of CMR.  Is that even possible?  I thought that in order to have CMR you had to have already reached CHR and then CCyR.  Or, did someone get the numbers backwards?

 

"The complete hematologic (blood based) response (no sign of active disease) rate to treatment was 50% in these patients. The complete cytogenic (chromosome based) response (decrease in abnormal chromosomes) rate was 71%. The complete molecular (molecule based) response (no sign of abnormal chromosomes) rate was 75%."

[Trey]

If CHR is defined in weird ways (such as all blood counts returned to normal) CHR rates can be very low, even lower than MMR and CMR/PCRU.  Some of mine have never returned to "normal" including MCV and MCH.  But they don't matter.  CHR should generally only be based on WBC and PLT.  Even RBC can stay low for many years.

Edited by Trey, 24 January 2018 - 04:33 PM.

[Red Cross Kirk]

Thanks Trey,

 

I think maybe the wonky numbers are the result of mixing different patient subsets together for this study.  Here's a snippet with more detail:

 

Patients and Methods

We retrospectively studied 12 adults with relapsed/refractory Ph+ acute lymphoblastic leukemia (n = 9) and chronic myeloid leukemia in blast crisis (n = 3), treated with the combination blinatumomab and a TKI (ponatinib, n = 8; dasatinib, n = 3; bosutinib, n = 1). All patients have previously failed at least 1 line of chemotherapy, including allogeneic stem cell transplantation, and 1 class of TKIs. Patients were treated for either overt hematologic relapse (n = 6) or persistent minimal residual disease following other regimens (n = 6).

Results

The complete hematologic, cytogenetic, and molecular response rates were 50% (3/6), 71% (5/7), and 75% (9/12), respectively. Two cases of grade 2 cytokine release syndrome were observed, all of which resolved with steroids and tocilizumab. No cardiovascular adverse events were encountered. With a median follow-up of 8 months, the median survival was not reached; the 6-month and 1-year overall survival rates were 73%.

[Trey]

Those numbers of patients (12) are too small to make any sense of using percentages anyway.

Edited by Trey, 24 January 2018 - 07:57 PM.