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Jump in PCR ABL after 2 yrs

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Hi All

I was diagnosed with CML in Dec 2017 and was on dasinitab 100 mg since them.  Achieved molecular remission in April 2018 and have since been ND

In 2020 my test in January was ND.  Unfortunately the test in July 2020 came with surprise with the PCR- ABL jumping to 6%

Also from June had this burning/heaty session in body hence had stopped the meds for a few days in June 2020 and restarted the same.

We followed with another test in July 25 where in the level came down slightly to 4.5%.  Now my blood has been sent for mutation studies 

The doctor feels that we should change the medicine to Nilotinib once the mutation studies come in.

Any views from the forum.  Am quite confused with the sudden change in my status

Thanks Jaideep

 

I was diagnosed 4 months before you.  I was also put on 100mg Dasatinib but never acheived MMR.  I got really close a couple of times but was switched to Nilotinib at about 21 months I believe.  Recently achieved MMR so another medication can certainly be helpful.  Being that your numbers rose between tests and relatively steeply it is possible that a mutation is present.  This is no cause for alarm however as once it is identified another TKI will probably work since you responded to the first TKI.  

I did notice that you mention your blood was sent for mutation studies, and I could be wrong, but I thought that mutation tests had to be done via bone marrow biopsy.  I switched to Nilotinib without a mutation test but my jump in BCR/ABL was 0.32 to 1.2.  I think mutation analysis should be done because if it is T315I then only Ponatinib can be effective so it would be good to know before the switch.  In either case I think that you will soon be back in MMR and on to better, less stressful things.  Take care.

Hey mate my mutation analysis was done on blood sample not bone marrow. Been waiting 4 months for the results so far. Slow slow slow. Did I say slow 🤣

After waiting 5 months following my providing a second sample, I have a result from the CLASS Trial which simply reports, "No AKD mutations".

The mutation analysis is performed on blood. This also applies to  the next generation sequencing technique.