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Gleevec resistance?

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Hello All,

I am new to the group. Hope you can help answer my question. 
History: I was diagnosed CML  in 2001. After 2-3 years On gleevec 400mg, I was in major molecular response and then undetectable (0.000) for around > 10 years or so while on 400mg gleevec.
Now suddenly last month in my last Bcd-abl it showed that I am 
0.018 and repeating it after a month, it's 0.021 so little bit higher than last one..
Is it considered gleevec resistance? Where I need to switch?

BTW:
I missed 3 doses or so in the last month and that is 
Where it (Bcd-abl by PCR) came 0.018 but not sure if 3 days can be that critical. Also I don't take medicine at the same time sometimes with breakfast sometimes with late lunch.  Can that suddenly change the response? 

Any thoughts or similar situation insight is much appreciated..
Thanks
Raj

Hi Raj, Welcome to the group. Your results have been outstanding for 10 years. I do feel that your " blips" are exactly that and not resistance. Your levels are still very very low and nothing in my view that I would worry about. I do not feel this is resistance and the two results are basically identical. Personally I would defiantly not switch as yet,. Missing more that 10% of doses has been shown to have an effect on response so this could be a factor. Moving times about for an hour or two, particularly if your system has a good level within it also will have little to no effect, however you are better to take a a very similar time daily as breakfast to a late lunch could be several hours difference. Let us know how the next result turns out.  Nigel

Hi Raj,

With regards to timing ... with imatinib, you are "topping up" a level in your body so breakfast or lunch ought not to make a difference really. Though it's best to take as close to the same time every day, imatinib is not massively sensitive to that. This is the message we were given at CML Horizons this year, anyway.

Have you asked if the PCR testing at your hospital lab has changed? Perhaps they have upgraded their machines or methodology? Often people move hospital and find their result changes, even though within themselves nothing has changed so the same might happen with a change in lab conditions.

David.