March 9, 2002
Hi All,
Dave had is 2-year check-up yesterday! We weren't expecting anything exciting at this visit, and it wasn't. His blood counts are in pretty good shape -- reds are still low, but not problematic. Whites and platelets are just where they should be (and have been for months). The doctor did a bone marrow biopsy. If the results are negative, this will the last one, so keep your fingers crossed!
As you may remember from my last message, there was no sign of the Philadelphia chromosomes, meaning Dave is in cytogenic remission, but the PCR test came back positive, which means he's not completely free and clear yet. The PCR test looks for the protein created by the Ph chromosome (bcr-abl), not the Ph chrom itself. Are you confused yet? (if not, read on!)
When looking for the Ph chrom, a sample of about 200 cells is used -- and in Dave's test, none were found. The PCR test uses a sample of about a million cells. Because the sample size is so much larger, there's a greater chance that any protein (created by Ph chrom cells that weren't found in the smaller sample) will be picked up, giving a PCR+ result. This is a pretty sensitive test, so only a little of the protein needs to be present to be picked up, and only a few of the Ph chrom cells are needed to create the protein (which is why they can be missed in the first test).
What we're hoping for this time is that the PCR test will come back negative, meaning the Ph chrom cells that created the protein which caused the positive reading last time have been eradicated, and Dave will then be in molecular remission. And it doesn't get any better than molecular remission (it's as free and clear as you can get)!
In the meantime, Dave will continue to take Gleevec. The doctor wants him to stay on it for a year following a PCR- result, so if this test isn't negative, he'll do another biopsy in 6 months, and we'll see where things stand then. We should have the results of this test back in early April, so I'll be sure to let you all know what we find out. And since it's been two years, Dave got 6 vaccinations, just like a 2-year old!
Hope this finds you all well.
Enjoy spring!
Allison