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Peripheral smear report shows 0% myeloblast
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No, it does not.
Bcr-abl is a measure of bcr-abl protein amount present in blood. Myeloblast percentage is a measure of how many blood cells are 'blasts' (short name for myeloblasts). Having zero percent myeloblast is very good when considering CML. It means your blast cells are differentiating quickly as they should (hence they don't show up in counts) into daughter cells. For most people it's common to have a few percent of blast cells*, but little more. When blast count (percentage) rises significantly or is high to begin with can indicate CML progression. This is why during TKI treatment, when blast cell percentage is zero, doctors/patients have time to work dosing and side effect strategies. CML in chronic phase (zero blasts) is relatively slow to develop.
(*Differentiation of blast cells is facilitated by vitamin D. Low vitamin D levels. Presence of blast cells in blood (normal or CML patients) can be an indicator for vitamin D deficiency.)
Thank you so much Scuba. My creatnine level increased to 1.5 and even Total count - increased fro 6600 to 10500 with 0% blast. Is it bcoz of tasigna?
Regards
Kiran
I have read recently about a 40 year old lady of Asian descent who had been diagnosed with CML. She responded very well to drug treatment, so well, in fact, that the treatment was discontinued.
Some time later, the CML raised its ugly head, treatment was restarted, but, it was not effective, and the disease had become extremely aggressive. She is in need of stem cell therapy as it is now her only option.
The unfortunate problem is that the donor databases do not have a particularly good number of Asian donors, and so her search to find one compatible with her is very difficult.
I have had CML for 15 years, and treatment with imatinib has been very successful. My last test showed that there was the lowest possible count for the cancer cells, 0.002%, which means that there must be millions of the little b******s still alive and kicking. I attend clinic every four months, to be told that I must stay on imatinib for the rest of my life. My blood is “perfect”. As I am now 69, and have other co-morbidites, I should think that it will be fairly soon that I will lose the fight.
The moral of this story?
If your treatment is successful, do not at any time accept a reduction in it or else your drug may no longer work, and, like the lady in the above report, you may need the last resort in your bid to stay alive.
Richard, your account of the issues the lady has experienced is very sad. There is good research to indicate that treatment free remission is achievable under conditions which are becoming better understood every year. This talk at the UK patient day explains the latest information, and there is a link in a recent post to a US LLS document on treatment free remission. This needs to be addressed on a case by case basis between the patient and their doctor.