Hi again
I really believe that your son is in a good place with 0.26% and that all this talk of transplant is premature. Are they perhaps considering it because he is reasonably young and they are hoping for a permanent cure? My own doctor was pleased when I reached 0.24%.
I'm attaching the citation of a very good article I read that discusses patients who reach below 1% (CCyR) but who don't reach below 0.1% (MMR). A quote from it reads:
"none [out of four major studies done] reported significant differences in survival in patients in CCyR by whether they did or did not achieve MMR. The reason CCyR became the gold standard for a favorable response to therapy in CML is because it is associated with a survival advantage. This is not the case for achievement of MMR. At present, achievement of CCyR remains the goal of TKI therapy in CML, although the additional achievement of MMR may protect against a higher probability of events and, to lesser extent, of transformation to the accelerated or blastic phases."
The article citation is:
Considerations in the Management of Patients With Philadelphia Chromosome–Positive Chronic Myeloid Leukemia Receiving Tyrosine Kinase Inhibitor Therapy
Hagop Kantarjian, Jorge Cortes
J Clin Oncol. 2011 Apr 20; 29(12): 1512–1516. Published online 2011 Mar 21. doi: 10.1200/JCO.2010.33.9176
PMCID: PMC4979098
Dr Cortes and Dr Kantarjian are two of the world's leading experts in CML and I would really trust their opinion that below 1% is and remains the gold standard for a good response! Believe me, I struggled for two years to reach MMR, was quite disappointed and worried by my own slow response and this article (and many other like it) provided me with a great deal of comfort!
Best of luck to you and your son. I think it may even be harder being a parent of a CML patient than being the patient himself!
Martin