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CML treatment success

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Hi there,
How much time it takes to have complete hematologic response? Does that mean all blood counts are totally in range like normal person or slightly lower than normal person. After this how long it takes for Cytogenic response which is a great milestone to achieve.
Thanks in advance.

Hi

The simple answer is that this varies very widely.

There are different levels of response to medication as measured by BCR-ABL testing as detailed on this page of this site. For normal blood measures see this page.

Guidelines state that an optimal response would be to get to MR3 12 months after starting TKI therapy. Some people get there in under 6 months, and some take more than 2 years. A small number need to change their meds because of lack of response or intolerable side effects but most will get there in the end.

I hope this helps.

There are various indices both predictive and prognostic which have been used ;for instance the SOKAL index for CML uses age,spleen size ,platelet counts and % myeloblasts count that were present on diagnosis.There is also EUTOS of which ELTS -Eutos Long Term Survival Score that uses different inputs and finally Euro (not the currency ! )Are these measures that might have been used more in the time say twenty years ago  pre introduction of tkis when interferon alpha was the last line of defence used.?

Has anyone had such an index computed for them by their specialist and has it been useful as a predictor or used as a guide to intervention and treatment?

Thanks

John

John,

The scoring mechanisms need quite a lot of medical background to really understand their prognostic value. Understanding them is way beyond any knowledge I have. I was scored EUTOS (low), SOKAL (high), Hasford (intermediate), and ELTS (high). SOKAL can be used to predict Complete Cytogenetic Response timeline - mine was predicted as 18 months.

But as you can imagine, since my scores go from each end of the spectrum I think the clinician really needs to understand exactly what each of these measures are saying.

You can calculate your own ELTS score here: https://www.leukemia-net.org/content/leukemias/cml/elts_score/index_eng....

David.