Dear Jacqui,
Your pcr result is very good, so you should be at least as happy as your contultant ;o) Congratulations.
Your September result was around 30% (28.34) which means that you still had quite a few PH+ cells evident (and visible in your blood sample looking down the microscope). However, as dasatinib has been doing the job it is hoped it would do, your PH+ cell population has dropped to a very low level... just under 1% (0.70) which is great.... the PH+ cells will probably not be evident if you looked at your sample down the microscope as the number is now so low. However, it does not mean that the PH+ cells have gone.... there are probably quite a few of them, it is just that the number is now only measurable by the molecular test we know as PCR which is a measure of the abnormal fusion-protein BCR/Abl and is expressed as a % ratio of normal cells vs abnormal cells in any one given blood/marrow sample. the presence of this protein shows that you still have PH+ cells somewhere in your marrow (not now visible in your peripheral blood) and therefor you still have CML.
for most of us who are treated with imatinib or the other two TKI's dasatinib or nilotinib, the abnormal protein BCR/Abl will always be evident and therefor will need to be kept at very low levels by the daily dose of one of the above drugs.
Some, like Des and Basil, do achieve such low levels of the protein that their PCR's are expressed as 0.000 (also known as PCRu - undetectable). If you remain PCRu consistently for over 2 years some clinicians think that this might be evidence of a 'functional cure' .. which means that some can come of TKI therapy and the disease remains dormant. However, this does not happen with all those in PCRu and a high proportion do start to show BCR/Abl positive PCR tests usually within 6 months of stopping treatment.
So for the majority therapy with TKI's like imatinib etc. is not a cure. We are still waiting for such a drug to be developed... and I am sure one day it will be.
I hope this is of some help.. if you need further explanation then please ask again,
Just know that you are doing very well on dasatinib and maybe you should take some time out to celebrate.
Best wishes,
Sandy
Sandy
