Darrens last lot of bmb showed no decrease in blast cells, still at 4 % is this normal, specialist said this shouldnt be happening but doesnt seem to concerned. He hasnt had a BMB since sept last year until today!
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Blast cells not decreasing
Hi
This is something to discuss with HH when you visit. I can't quite tell from your posts which results you're referring to and whether they are blood or bone marrow (you say bmb but I'm a bit confused as to how many bone marrow's Darren has had since diagnosis and when they were, including how recent).
First point though is that 4% is chronic phase. If blood, the answer is that normal blood should have no blasts and over time glivec and other TKIs should bring the number in blood down to zero. not sure about the marrow - someone else may know whether a small percentage is in normal marrow - but as 4% is chronic, that's good and HH can advise what steps to take for a better response. Maybe stay on the higher dose glivec or shift to another TKI. They're the experts and will advise you.
Re timing of marrows, given Darren's initial diagnosis and pcr history, I think he should have had one at 6 months post diagnosis and again at 12. HH may want to do another of their own to get a base line for them.
As Darren's marrow biiopsy/aspirate is showing the presence of Blast cells at 4% I think he should be - at the very least- be monitored at 4 week intervals with bmb's as and when it is thought appropriate depending on blood level results. If blast cells are only seen in the marrow then it is of some comfort, but I would say that he should be carefully monitored and at an expert CML centre.
When i was diagnosed I had evidence of blast cells in the marrow at 5%... this was a 'flag' to the haematologist that I might be at risk. He referred me immediately to HH (he could have chosen another centre but it was my luck that he sent me to HH) who then did there own tests. This was before imatinib but I am telling you this because the presence of blasts in the marrow is an important indicator that the disease should be carefully monitored...... and certainly not every 6 months. I am pcr U and still need to have pcr's every 6 months!
I hope you can get access to expert advice asap.
Sandy
he was reffered to HH last week as after 18 months of treatment his BCR's have started to increase, never got lower than 4% and now its up. His care has been terrible in my opinion and we are quite happy to be referred to HH. These BMB results should be back intime for his normal appointment on 8th, so i guess they will know blast % by then, just hope it hasnt increased like the BCR. His BCRs are back to where they were last Aug !