Hi everybody.
My mother was diagnosed with CML about 10 months Ago and she is on imatinib 400 and today we got her PCR examination results and it was 0.00299 but the previous one (about 6 months ago) was 0.002 on international scale.
Now we are confused!Is this good or bad news? Is imatinib working good or bad for her?
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PCR results after 1 year
Hi,
That's an awesome result!
Major Molecular Response, MMR or MR3, is usually considered the "safe haven" level, when it comes to PCR tests. MMR is 0.1%. Once a patient is below (and maintains below) this level, the chances of disease progression are low.
The next level after MMR is "MR4" which is a 'deeper' response. That is 0.01%.
After that, there is MR4.5 which is 0.003%, and further beyond that MR5 which is 0.001%.
So, your mother is doing fantastically at MR4.5 (or lower).
Depending on her age, and the side effects she experiences she could in some time be eligible to attempt to stop taking imatinib and seeing if CML stays extremely low. For some people, they can stay off the drugs and the PCR doesn't rise. Lots of personal factors would go in to whether she eventually decided to try this. Others here will be able to give much more info about this as some of them are going through these trials.
David.
Hi Shafagh
A wonderful result for your mother again. She has reacted very well to imatinib to achieve such good results so quickly and to hold it. The extra .00099 don't mean anything as far as I know. Imatinib is certainly doing a very good job for her so don't worry - celebrate.
Best
Chrissie
You should be celebrating your mothers 2 PCR results. The first - 6 months ago- (so only 4 months after she started therapy) is an optimal results to say the least! 0.002% on the IS means her level of residual disease is about as low as most CML patients can ever hope for.
Her most recent result - 6 months after starting therapy- is the same as the first - they have just added a few more numbers, but as Chrissie suggests and I agree- ignore them! They are just a little added detail by the lab. If you looked at the first result in that kind of detail then it would probably have the same numbers.
But at this kind of low molecular level you should not worry about small changes...
It is more than likely that her next result will be similar or the same. And as David says, anything under MR3 (0.01% IS) is considered to be a 'safe haven' with very little chance of disease progression.
David also outlined the percentage reductions of BCR-ABL transcripts as they are understood from PCR results on the international scale (IS)- your mothers two results are between MR4.5(0.032% IS) and MR5(0.001%IS). Tell your mum and your family to be very happy with that. Imatinib is working very well for her.
Sandy