Dear Lee, The most recent monitoring recommendations come from MD Anderson Cancer Center.
The 'Hybrid' Approach * This is the recommended approach by CML Experts from MD Anderson Cancer Center. * Pretreatment bone marrow CA is favored as it can aid prognosis since it can measure the percent of blasts, basophils and clonal evolution in the marrow. * Although FISH and PCR are not recommended at diagnosis unless physicians wish to routinely monitor by these techniques and rely on them before CCR, these techniques do reveal to the physician that the disease is measurable by FISH and PCR and a baseline established. * BMA CA are recommended at 6 and 12 months, then once every 1-2 years after CCR. * If Ph negative chromosomal abnormalities prove to be clinically insignificant by further studies, then marrow analysis can be performed at more than 2 years interval after a CCR. * FISH is recommended every 3 months from the blood until the test is negative. FISH studies should be omitted when a marrow CA is performed. After CCR, FISH should not be done, only serial monitoring by QPCR studies. * Patients can be monitored by PCR every 3 months in the first 12 months, then every 6 months once a stable complete cytogenetic response is achieved. * If a PCR shows a patient to be out of MMR or show a rising PCR trend, there should be a repeat PCR, more frequent monitoring like every 3 months and repetition of a bone marrow cytogenetics, especially if the PCR is above 1%. * Variations in PCR of a CCR patients should not dictate a change of therapy to allogeneic transplant. * In a patient who is in CCR but the PCR has risen consistently to more than 5-fold or has gone out of MMR, it may be reasonable to increase Gleevec dose or switch to a 2nd generation tyrosine kinase inhibitor if the Gleevec dose increase is not effective. 'Monitoring the Response and Course of Chronic Myeloid Leukemia in the Modern Era of BCR- ABL Tyrosine Kinase Inhibitors: Practical Advice on the Use and Interpretation of Monitoring Methods' by Hagop Kantarjian, M. D., Charles Schiffer, M.D., Dan Jones, M.D., Jorge Cortes, M.D.1 published Nov 30, 2007 in Blood. Hope this helps. Best Wishes, Anjana wife of Roy d/x Jan 2002 400mg Gleevec PCR 3.9log --~--~---------~--~----~------------~-------~--~----~ [CMLHope] A support group of http://cmlhope.com ------------------------------------------------- You received this message because you are subscribed to the Google Groups "CMLHope" group. To post to this group, send email to CMLHope@googlegroups.com To unsubscribe from this group, send email to [EMAIL PROTECTED] For more options, visit this group at http://groups.google.com/group/CMLHope -~----------~----~----~----~------~----~------~--~---
