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BCR-ABL %

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Hello Friends,

I have been diagnosed with CML in September 2018 and the BCR-ABL% are as follows: (I am on Imatinib 400mg since start)

5-Sep-2018  - 46.65

8-Dec-2018  - 16.67

9-Mar-2019  - 0.95

7-Sep-2019 - 0.16

7-Mar-2020 - Not Detected

5-Sep-2020 - 0.11

5-Dec-2020 - Not Detected

5-Jun-2021 - 0.068

4-Sep-2021 - 0.027

5-Mar-2022  - 0.026

As per the last report my doctor has suggested to redo the test after 3 months (June 2022) and said that I should be Deep molecular response by now. So based on the next report, he might increase the dosage or change medication.

Little worried about the last report (0.026 %) based on the what doctor said.

Any help and guidance would be great.

VinayJagnani. 0.026 is a very low level.   At BCR-ABL levels under 1.0, CML presents no danger to a patients health.  One of the biggest mistakes Oncs/Hemos make is increasing dosage, when the CML is already at a very low level, in an attempt to drive it to undetected.  More often than not this presents a danger from the high TKI dosage.

You are fine.  Plateaus, like the one you are in, normally drift lower with time, and do so, regardless of dosage.  

There is no reason to increase dose at these levels. You can remain here for months before you see another drop. Or it can increase slightly before coming down again. It is like small ripples with an overall trend down. Look for bigger spikes or a consistent trend up before making decisions to change. I speak from experience and also from reading countless other people's experience and studies. If it stayed 0.026 forever I still would not change. I know of someone at 0.02 for over seven years. It may be lower now, or the same but I know they are doing well. It was two years ago that I spoke to them about their numbers. You are in good shape. Your body is responding to TKI so that is great.

Hello Friends,

Thanks everyone for the response. Its so reassuring to hear so positive response and happy to hear that this is common.

I feel so much better now.

Thank You.

I would not say that it is common but it is nothing to worry about. Being under 1% good news, and .026 even better. I don't know your age but I have noticed on this and other forums that younger patients (25-45) numbers go down slower.

Age 34 here I was diagnosed at 28 my PCR result bounces between .02 and .08. Seems as of recent people have been seeing more fluctuations in their PCR results as well. I believe this maybe due to PCR machines being used more than ever before with COVID-19 testing. Also one thing I always try to keep in mind is that the actual variance of the test is half a log, from Mayo Clinic…

“The precision of this assay at low BCR/ABL1 levels is more variable, such that inter-run variation can be as high as + or - 0.5 log. Only level changes above 0.5 log should be considered clinically significant. For example, if a result is given as 0.1% BCR/ABL1:ABL1,then any result between 0.05% and 0.5% should be considered essentially equivalent.”