2 replies to this topic

[discovery]

Hi,

I am a brand new member of this site.  I found out I had CML about 6 months ago.  I recently went to my doctor and he told me "good news".  After taking Gleevec, for several months I am now in molecular complete remission.  He did tell me about it, but not in so much detail.  I was curious about if anyone on this site can explain to me more about molecular complete remission and any other relevance to molecular complete remission.  Anything would be most appreciated.

[Trey]

Complete Molecular Response (CMR) is the deepest level of response currently measurable.  It is also called PCR Undetectable (PCRU) or PCR-negative.  As the name implies, the PCR test can no longer detect the CML.  Leukemic cells are still there, although fewer than 1 in a million.  Six months would be a very fast response, so just to be certain, I would advise double checking with the Onc that it is indeed a negative PCR test.  Even Oncs get confused and call other negative tests by the wrong name (especially FISH test results).  I would also wait to see that the next PCR is also negative, since sometimes the PCR results can be wrong.  Not trying to rain on the parade, but some of us apply some caution to Onc statements that are not backed up with good explanations and test result print-outs.  But we will assume congratulations are in order.

Stages of CML Response:

Diagnosis: A zero response baseline from which to measure response to therapy

Complete Hematological Response (CHR): The WBC and platelets return to normal ranges and the spleen shrinks back to normal size

Complete Cytogenetic Response (CCR): Either a BMB or a FISH is negative, or 2-log PCR reduction

Major Molecular Response (MMR): PCR shows a 3 log (1000-fold) reduction in leukemia from diagnosis levels or lab baseline average

Complete Molecular Response (CMR): PCR is negative/undetectable (PCRU), so BCR-ABL transcripts are undetectable by PCR testing (leukemia levels too low to detect)

Cure: 5 years of continuous PCRU with no therapy (this is truly "remission") -- rare today without a BM transplant, but research looks promising and could change that some day soon.

Also see:

http://community.lls.org/thread/1576?tstart=0

[JJR]

Trey,

Thanks again for your great info, by the way what is your profession, is it in the sciences? And how to you personally go about researching this info?  Any tips? I have been using info from ASCO and Pub Med but would like to know your strategies...

JJR