Hi
I was going through many earlier posting , and I have noticed that patients with lower WBC load at the time of diagnose , achieves key treatment miles stones faster than others having higher WBC . Can any one followed this trend ?
Low WBC ( among CML population ) means Low CML load in blood ?
Thomas
I don't know about any studies of this, but anecdotally I can only add that I started out with just under 200x10^9/L, BCR-Abl ratio of 320% and 14 months later I am yet to hit MMR (0.4% on the chart now, so not too far away). I did get to CCR in around 12 months though.
I think the analogy I have heard is that if you find yourself in a swimming pool with a shark, and need to swim to the other side to safety ... in the long run do you really mind if it takes you 10 seconds or 1 minute to get there, so long as you get the in the end?
Low WBC in peripheral blood does not necessarily mean a low leukaemic load. At diagnosis I had a wbc of just 17- hardly higher than normal levels. However, my platelets were pretty high and rising, I had a fibrotic marrow and a very enlarged spleen.
The low wbc was explained to me several years later. Most of my leukaemic cells had taken up residence in my spleen. It was the other factors that were the reason that I was diagnosed in late chronic/acclerated phase.
I still responded to imatinib -although reaching CCyR very slowly (18 mths)- but after 3 years I started to lose my response because I had an imatinib resistant mutation. Nevertheless I am still here 15 years on that thanks to my brother I was able to have an HLA matched SCT.
Try not to worry too much- you are responding very well and within the guidelines for optimal response, but more importantly, since I was first diagnosed the number of TKIs has risen from 1 to 5.
Sandy
