Posted 21 April 2011 - 11:16 AM
The four general stages of treatment are:
beginning at 100 when diagnosed
hematologic response - means that blood cell counts have normalized
cytogenetic response - a reduction to <1 a 2 log reduction
major molecular response - a reduction to <0.1 a 3-log reduction
complete molecular response - a reduction to <0.01 a 4 log reduction
A hematologic response means that blood cell counts have normalized-most patients achieve a hematologic response on Gleevec. A cytogenetic response means there are no Leukemic cells (Ph+ cells) that can be detected by the FISH and cytogenetic tests. PCR is a very sensitive test that looks for Ph+ cells (the trademark of CML) in the blood. When initially diagnosed, the average patient has a 100 (int'l scaled) score on the PCR test. That score usually drops to around a 1.0 when the patient achieves a complete cytogenetic response. And when the PCR score drops to 0.1, the patient is deemed to have achieved a major molecular response. Achieving a major molecular response within the first 18 months of treatment is important, because most of the patients that achieve that benchmark remain "free from progression" to more accelerated forms of the disease five years later. (Gleevec is still a relatively new drug, so we don't have a lot of data beyond 5 years out.) A complete molecular response usually means a score less than 0.01, a level below what the lab is able to detect in the patient's blood-what is called "remission" in cancer terminology. Unfortunately, Gleevec is not a "cure," so patients who are successful on the drug usually remain on the drug indefinitely to stay in remission.
For the benefit of yourself and others please add your CML history into your Signature
02/2010 Gleevec 400mg
2011 Two weakly positives, PCRU, weakly positive
2012 PCRU, PCRU, PCRU, PCRU
2013 PCRU, PCRU, PCRU, weakly positive
2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)
2015 300, 250, 200, 150
2016 100, 50/100, 100, 10/17 TFR
2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000
2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17
At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.
In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.
longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation. GFR and creatinine vastly improved after stopping Gleevec.
Cumulative Gleevec dosage estimated at 830 grams
Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.
Trey's CML Blog - Stopping - The Odds - Stop Studies - Discussion Forum Cessation Study
Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt