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New Basophils (1% and absolute value of .1) but with decreasing PCR 0.008

I recently had my lowest PCR yet 0.008 and on just 50mg which I was very very happy about. However my oncologist contacted me today wants me to return in a three weeks for another CBC and a periphial blood smear because my last two CBCs showed 1% basophils and my most recent showed an absolute value of .1 basophils. I have always had 0 for both of these values (abs and %) in the past years, and they are still within range and by WBC is 7,2 also in range. This was my second monthly PCR since reducing my dose to 50mg and I was so happy to see my PCR decreasing but now i'm scared again continuing on 50mg. This has me f freaked me out a bit, has anyone else had basophils increase as their PCR is going down possibly when doing dose reduction or maybe even cessation. My only thought was maybe the 50mg is relieving some of the overall myelosuppresion which allowed the basophils to increase (since they are still within normal range on the reports). 

 

 

I suspect nothing to worry about at all. The fact your PCR is below precision limit of the test (i.e. PCR < 0.01%) suggests your CML is no longer an issue. Basophills rise and fall as the body needs them. You were likely exposed to some external inflammation triggering event. Diet can affect Basophil count as well.

I don't pay much attention to "percentage" of blood cell. Absolute count is more useful when it comes to CML. Percentage of cells will naturally change as your body calls for one type of cell over another depending on what you are exposed. In fact, as we transition from fall to winter and decreasing sunlight (e.g. Chicago!), your body is changing the makeup of your blood cell types (within range typically). That could easily explain what is happening. The only cell count percentage which matters is blast cell level. Usually that level should be zero or a few percent - but mostly zero if your cells are differentiating properly.

As long as you are in range - or even close to 'in range', you are doing fine. Also - at your PCR level, you might consider lowering your sprycel dose even further (to 20 mg). The less drug you take and it still work, the better. You are looking for your personal dose which works. At 0.00x, you have a lot of time to experiment. CML is slow when in chronic phase. This is why it is becoming practice for women who have CML and want to become pregnant to stop treatment and go a full nine months even with CML increasing during the nine months with little impact on CML treatment following pregnancy.