hi.
this is my first time posting here.i was diagnosed with cml nine months ago and i went on gleevec.
first diagnosed my pcr was 53%,the second one after taking gleevec for 3 months was 18% the dr said we will wait till next pcr if it is not under 10 we have to switch to second generation tki.the next pcr was 2.1 after six months of gleevec it was good with 1.6 log reduction.
the thing that my latest pcr which is after 9 monts of gleevec is 1.47 with 1.8 log reduction,the dr told me that its a bit slow but within the range, we will wait the next pcr if not under 1 we have to swich to 2nd generation.for the last three months i used the teva imatinib (generic) she told me it has equivalent efficacity to gleevec.
i need your experience and opinion about my case and i do appreciate what you are sharing on this site.thanks in advance
You are here
slow response to imatinib
Hello there, and welcome!
Firstly, do you know if your PCR results are reported on the International Scale? If you're not sure, it's worth asking your doctor as that helps give a better understanding of your response.
Though your progress has been a little slower than optimal, the direction of travel is a downwards trend, which is really important. If you are doing well on imatinib in terms of side effects and it is working slowly-but-surely then my thoughts are to stick with it so long as that trend continues downwards.
For what it's worth, after 3 months my PCR was 22.6%, and after 9 months was 1.04% - so quite comparable to your results (but I take dasatinib). Now four years later it's down to about 0.01%, so it goes to show that even though some of us are slow starters we get to an excellent PCR result in the end.
This card from European LeukaemiaNet may be useful to you. So you can see that at six months you were in the "Warning" position, but right at the lower end of it. Your next PCR result at 12 months will show if you've moved from Warning to "Optimal" (i.e. MMR / MR3), but even then I would not get too stressed - after 12 months I did not meet the criteria for an Optimal response, but doing great now. I didn't meet the criteria for MMR / MR3 until two years post-diagnosis.
David.
hi David
thanks for replying, your answer was very clear and relaxing that i am gonna do it one day :)
i will ask my dr about the international scale next time and send you my latest pcr.
Iffat
I had a sub optimal response at 3 months (we switched to Tasigna but changed back to Imatanib after a few weeks due to eye bleeds) and a very good one by 6 months.
From a video on this forum, I learned that slow responses have NO significant impact on life expectancy, a fast response only relates to a patients eventual possibility of coming off meds or reducing dose.