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BCR-ABL1IS-QUANTITATIVE TEST RESULT

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Hi My Dad was diagnosed CML 25 years back, he is now 73 years old. He was using  Imatinib 6 months back and during the  BCR-ABL1IS-QUANTITATIVE TEST RESULT BCR-ABL1 IS -NCN  came as 57% and doctors recommended to use Tasigna (Nilotinib) 600 mg daily. Last 3-4 months because of other complications he didn't use these medicines regularly. A few days back doctor asked dot he test again we got the report with result BCR-ABL1 IS -NCN -102%  We are all worried whether these medicine is working ? is it right medicine. Any suggestions will help. I would like to attach the report but not able to as attach media button is not working. We would like to know how serious is the situation and what are the other treatment options. 

Here is some other detail from the report 

 

BCR-ABL1 IS -NCN :102.624%

BCR ABL1-CN :964000

ABL1-CN: 939350

IS-CAL(CF): 0.121

IS-CAL -NCN: 0.121

Hi Ramesh,

I have some questions:

Given your father has had CML for 25years, can I ask how he has been treated before he was given imatinib (6 months back)?

I assume the PCR test result you quote as 57% was his 6 months PCR test result?

I would advise you that no matter which TKi is taken- whether that is imatinib, dasatinib, nilotinib, bosutinib or ponatinib - if a patient does not take the prescribed dose every day, and in the case of nilotinib 2 times per day with 2 hours fasting before each dose, it is very unlikely that the disease will be adequately controlled and the PCR results will reflect this. If a patient regularly misses even just 2 doses of their TKi therapy in one month the risk of disease progression rises. As your father's disease is not yet adequately controlled the risk increases.

I think, if possible, you or your family need to talk with your father's clinician about his lack of adherence to therapy (maybe because of the strict fasting regime required with nilotinib) and ask if there is another 2 GenTKi that he could take to help encourage his daily adherence.

Sandy