What is Chronic Myelogenous Leukemia CML
Chronic myelogenous leukemia (or CML) is a form of chronic leukemia characterized by increased production of myeloid cells in the bone marrow. It is a type of myeloproliferative di...
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CML Goals
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Can some of you share for those of us who have been diagnosed in the last 6-7 months what "goal marks" we should be shooting for. Is bone marrow biopsy for most of you done at diagnosis and then again at 6 months or 1 year. Also, what numbers are the most important markers to know from blood work? My doctor hasn't really shared my results other than to tell me I am either OK or on one occasion that I needed an infusion of red cells. Unfortunately my husband had a major heart attack right before my diagnosis and alot of my focus has been on him; much less on what I should know about important CML goals and numbers. I am in a hematologic remission but what do you think are the most important questions to be asking of the doctors? Many thanks to all of you who take the time to respond.
Posted on 10/13/09, 04:10 pm |
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Well, my diagnosis is more like 2 1/2 years ago, but here's what I was told: 1. Complete hematologic response (i.e., your blood counts look normal): 3-6 months. 2. Cytogenic response (i.e. from BMB): some response in 6 months, major response (i.e., no more than 35% Ph+) within 12 months complete response (i.e., 0% Ph+) within 18 months. 3. Molecular response (i.e., PCR results): ultimately, you want to have a 3 log reduction in the BCR-ABL ratio (i.e., the number is 1 1/1000th of what it was initially); becoming PCR undetectable (PCRU) is great, but apparently not necessary. If you fail to meet these guidelines, they'll try one of the other TKIs. If you show complete cytogenic response for two times in a row, they may decide to stop doing BMBs and just do PCR tests. You might want to take a look at the national cancer care network guidelines (start at nccn.org). You have to register to get access, but registration is free. Sorry to hear about your husband; I hope all is well. 
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Thank you. This is very helpful and I will make sure that I ask my doctor for a copy of my bloodwork to really look at the numbers.
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You may want to check out http://www.cmlinfo.org The section on CML monitoring. It has the latest CML expert doctor recommendations for CML milestones. I will update the milestones after the 2009 ASH meeting recommendations.
Regards, Anjana wife of Royston d/x Jan 2002 400mg Gleevec PCR 4-log reduction
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Anjana: Thank you so much - your site is great and I think it is the most comprehensive information I have been able to find online. I feel that I now will have the knowledge to talk to my doctor with more authority about my treatment and expectations. Bless you for all of your support and good wishes to you and your husband. Marcie
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