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.
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Hi Myra
From my own experience, I achieved the complete haematologic response in 6 weeks after being diagnosed. But this included a week of hydroxyurea therapy before getting started on dasatinib. It means that all blood counts are close to the normal range - many patients suffer pancytopenia or neutropenia, where some of the blood counts are actually below the normal range, especially the white blood cells. This sometimes requires a dose interruption or various other interventions to manage until they recover, and some patients stay at the lower side of normal for the rest of their treatment.
For example, my white blood cells are almost always very close to 4 on my blood tests (4 is the bottom range of normal) and my platelets are also generally at or below the lowest range of 150. Despite this, my doctor says that my immune system is healthy and can handle normal viruses and infections (I've hardly been sick with other conditions alone diagnosis).
Complete cytogenetic response is when there are no more leukemic cells detectable in the bone marrow and is a great place to be. This corresponds roughly to a BCR-Abl level of 1% and the current guidelines expect that most patients who respond optimally will achieve it in 6 months after starting treatment. In my case, I just missed this milestone after 6 months but attained it at my 9 month test, so I guess it took me around 7 months to achieve, but I am a very slow responder.
Others will surely comment and explain better than I have, but I hope this helps!
Best wishes for a speedy recovery from South Africa
Martin
Thank you Martin for your response. His blood levels have improved a lot and are stable from last 3 weeks but still he needs to go for blood test every week. I think they are observing his neutrophils count which is 2 and in normal range on the lower end. For 1 week he was out of medication because of low counts but after that they are in normal range.
I'm waiting for the time when he just need blood test once a month. When will that happen?
It's hard to say when they will move to monthly blood tests because they are monitoring him for low counts (making him more prone to infections). At the beginning it is all about managing toxicity and its trade-off, efficiency. I was lucky that my counts were never so low that I had to interrupt my dosage, and I moved to three-monthly blood tests almost immediately.
Others on the forum have had issues with low blood counts and they should be able to give you better advice, but I would imagine that, once they are satisfied that the dosage of the medication is not hampering his immune system and putting him at risk of other illnesses, they will go to the three-monthly tests. Low blood counts are a common complication of therapy on these drugs and it sometimes takes some time for things to settle as the body adjusts, so I guess they are just playing it safe. I'm sure that with three or four consecutive stable blood counts while on the medication, they will move to less frequent testing!
With my good wishes that this happens sooner rather than later,
Martin