Doesn't PCR testing give you the best results where bone marrow testing is not even being done by some doctors or is a necessary evil that has to be performed at 6 months and 12 months to check for a complete cytogentic response and then eventually a hematological response. My new hematologist wants to do a BMB on me next week to see where I am to gauge what response I had so far on Gleevec and wants to switch me over to Tasigna from Gleevec since I am in a higher risk category to advance and low blood counts. When I was diagnosed in October of this year, I was treated with hydoxurea and Gleevec at the same time and could have played a part into why my counts won't hold in the normal and always drop off. Any thoughts on this?
Bone Marrow Testing?
Posted 25 December 2010 - 05:51 PM
My new hematologist is one of the doctors on the NCCN Treatment Guidlelines panel so I think I am in much better hands compared to before. I had one onc saying keep me off Gleevec until my counts come down which sounds correct from what I know today and the other onc in the same off put me on Gleevec prior to seeing all the reports come back. Sounds like although it did me good to be on Gleevec and Hydroxurea at the same time, it has affected by bone marrow production as well with some lingering effects still possible in my system since I have been off the hydroxurea for a month and 1/2 now. Thoughts on this as well? I apologize if this sounds choppy, I just have a ton of info in my head now.
Posted 26 December 2010 - 03:08 PM
The bone marrow test looks at some other things besides if the cell is PH+ or not. The marrow testing looks at the quality of the marrow, and I believe most importantly, how many blasts are in the marrow, which is the way they determine what phase you are in. We all want to stay in chronic phase for as long as possible, so if your blast count in marrow starts to increase too high, they need to act on it (increase dosage, switch drugs, etc). The marrow test is a necessary evil early on in treatment. I believe if you hit all the milestones and get to a 3 log reduction in PCR and hold it, they don't have to do the bone marrow tests anymore unless your counts start to go up. The BMB is unpleasant, but everyone handles it differently; for me, I don't find it to be too bad. I have had two so far, with just the local anesthetic. Again, unpleasant, but not that bad. If you have a hard time with it, you can push the doctor for sedation, and they will knock you out for the procedure.
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