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Time for a different TKI or stay the course?

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Hello friends, I was diagnosed April 2017. It took 21 months for me to achieve MMR on 400 mg generic imatinib. I'm still taking IM.

At my last checkup this week at 33 months out, I am still not undetected. My numbers are

April 2017               49.0364% (all are IS b3a2)

July 2017                  5.6606  

September 2017       0.498

December 2017        0.368

March 2018               0.207

June 2018                  0.19

September 2018        0.168 

December 2018         0.0924     MMR

March 2019                0.0686     MMR

June 2019                   0.0154     MMR

October 2019              0.0831     MMR

December 2019          0.0931     MMR

 

Should I be tested for a mutation? And/or switch to a different TKI?

My health is good, so I'm not terribly worried, but sure would like to get on a path toward TFR!

Thanks for any thoughts.

Happy New Year!

I think you are doing fine. You may never reach undetected not everyone does. The guidelines for mutation testing or a switch of drugs is x2 consecutive upticks. But I bet if you test again you’ll be lower than the last result if not you may be resistant requiring a change in TKI

You’re in MMR - an optimal response. You’re doing just fine!

TFR is not a realistic goal for everyone.

If you really want the fabled “undetected” (7 years later, I’ve never had one) all you have to do is find a really shitty lab. Better ones will detect very low levels where a crap lab would declare “undetected” on the same blood sample. 

David.

Thank you both for your replies. Happy new year!