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what to expect

Hi All

Hope you are all well.

I am coming up to my first anniversary of CML and have the annual tests coming up. i will be having my BMB shortly just to say in advance OUCH. although i am lucky as i only have to have them annually. My question is, where can i expect to be up to after 12 months? my last PCR was in Oct and my result was 5.5% although i have not had another PCR test since. I am kind of hoping to have my first zero but will be happy as long as nothing as gone up.

what should i expect the bmb to come back as?

 

Also since being on my meds 400mg Immatinib i have noticed that i bruise so easily, but my platelets are fine. Is this normal?

Sorry for the long list of q's

 

Also just wanted to express my saddness at the news over christmas with the deaths, it deeply saddened me and my thoughts are with the families.

Anyway thanks in advance,

Naomii x

Hi Naomii, the following ELNet guidlines outline the 'optimal' response at 3, 6 and 12 months. 

The current (2009) ELNet guidelines indicate an optimal response (to 400mg imatinib) would be as follows:

 

3 months- CHR - complete haematological response AND some kind of cytogenetic response

i.e a ratio of < (less than) 66% Ph+ cells compared to normal cells.

 

At 6 months, MCyR- Major Cytogenetic Response  < 36% ratio of Ph+ cells.
 
 

at 12 months,  CCyR (complete cytogenetic response) i.e ratio < 1.5- 2% Ph+ cells 
 
then ongoing downward drop to a Major Molecular Response (MMR- e.g 0.08)

then down towards a 3 log reduction (0.003%) or less, (a complete molecular response) on the 'International Scale'.

These are 'guidelines' and we should remember that we are all individuals and some people respond slower or faster than others.

Hope this helps and good luck with the bma/b, hope it is not too painful.

 

Best, Sandy

I have had some discussions about what you should expect to see at the 3 months pcr.... there is now some confusion regarding the conversions to the  International Scale (now used at the HH lab amongs other CML specialist labs)... there is a conversion factor to take into account if the lab is not using the IS... it is as follows.

the PCR has to be expressed in the international scale (IS).... for this you need the conversion factor of the specific lab

for example:

PCR 11%

Conversion factor of Hammersmith: 0.299

PCR expressed in the international scale = 11% x 0.299 = 3.29% (good result for three months)

The ELN recommendations are not up to date

 

It is my understanding the the ELN guidelines will be updated in summer this year.

 

Sandy