NCCN 3rd Annual Congress - CML 11/05/08

November 6, 2008

Hi, did you know that at the Hutch, they are celebrating the 50th anniversary of

the first BMT? Here is part of the report from the 3rd Annual Congress dated

this date.

" One of the things we want to lead off with is how you should assess response in

this disease, and there are various levels. First is complete hematological

response. That is just looking at blood counts. You want to see a normalization

of those blood counts, and you need to see a normalization of those blood counts

by 3 months of therapy. Then, we go to the next level with cytogenetic response

that obviously has to be done with a bone marrow aspirate. You can go from

having no cytogenetic response to a partial response, which means that you still

have a fair amount of metaphases left, and down to a complete cytogenetic

response, which is what you really want.

" Regarding the criteria for response, you usually need to see a major

cytogenetic response, which means two-thirds of the Philadelphia chromosomes

have to be eliminated by 12 months, and we would like to see a complete

cytogenetic response by 12 to 18 months. In this molecular response, which is

even a finer response, that is typically done in patients who are

cytogenetically negative, and those are defined a couple of ways in the

literature. One is by the major molecular response, and what this means is a

3-log reduction in the mRNA level of bcr-abl from a baseline, so a thousand-fold

decrease. And then there is the complete molecular response, which means that

the disease is undetectable by reverse transcriptase (RT-) PCR. This is a term

that many of us do not like to use, because the undetectable rate varies from

lab to lab considerably based on how good their assay is. You can make people

have a complete molecular response by simply sending your assay to a bad lab,

and that probably should not count. " You will find the rest of this

FYI,

Lottie

Recommended Posts