tag:blogger.com,1999:blog-19490962.post3384450820841807742..comments2023-12-10T10:06:41.979+00:00Comments on mutations of mortality: Late treatment in CLLTerry Hamblinhttp://www.blogger.com/profile/06346629921055055879noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-19490962.post-20959310063845806382007-11-02T09:16:00.000+00:002007-11-02T09:16:00.000+00:00Richard - the backwards extrapolation idea does no...Richard - the backwards extrapolation idea does not work in practice because the blood compartment does not represent a contsnt proportion of the total available space for expansion over the course of the illness.<BR/><BR/>Vance - lead time bias is a real problem. just as it is with conditions like MDS and other diseases that are clinically silent for a long time.<BR/><BR/>Jenny Lou - its not quite as simple as that. There are some patients with good prognosis markers that behave like that too.<BR/><BR/>John, that is probably true.<BR/><BR/>Justme - So am I. There are obviously unidentified adverse factors.Terry Hamblinhttps://www.blogger.com/profile/06346629921055055879noreply@blogger.comtag:blogger.com,1999:blog-19490962.post-32385951914757827912007-10-31T01:33:00.000+00:002007-10-31T01:33:00.000+00:00I am very curious to know why some who have all go...I am very curious to know why some who have all good prognostic markers progress, when most others with those same markers don't.justmehttps://www.blogger.com/profile/00432622549940230450noreply@blogger.comtag:blogger.com,1999:blog-19490962.post-4184361250998203802007-10-30T16:18:00.000+00:002007-10-30T16:18:00.000+00:00While the ALC may not be a reason to treat on an i...While the ALC may not be a reason to treat on an individual basis, I would think that if the average ALC at diagnosis for the group that was treated was significantly higher than for the untreated group it may suggest that they were diagnosed later in the course of their CLL.<BR/><BR/>John ListonAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-19490962.post-34018422754806303972007-10-30T12:03:00.000+00:002007-10-30T12:03:00.000+00:00This continues to be interesting. Is it correct t...This continues to be interesting. Is it correct that cller's with the worst prognostic marker's, (unmutated, CD38, Zap 70+) seem to make it OK for the first 6 years post dx and then the survival line falls at a rapid clip? That is where I see that newer treatment just might stop this runaway decline.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19490962.post-42128348188619289432007-10-30T00:02:00.000+00:002007-10-30T00:02:00.000+00:00I have wondered about lead-time bias, especially w...I have wondered about lead-time bias, especially with the wider availability of flow cytometry which allows us to detect CLL at lower WBC levels, <I>vis a vis</I> the older definitions which were based upon an arbitrary absolute lymphocyte count.Vancehttps://www.blogger.com/profile/00420873277607900142noreply@blogger.comtag:blogger.com,1999:blog-19490962.post-57710743578857365782007-10-29T19:28:00.000+00:002007-10-29T19:28:00.000+00:00"Survival since diagnosis" seems to me to tell one..."Survival since diagnosis" seems to me to tell one as much about the efficiency of the health service or the GP as it does about the progress of CLL. <BR/><BR/>For people who are diagnosed after their have counts reach 5e9/L would it not be better to least squares fit their counts to a straight line(log plot)and extrapolate back to find the time when their count would have been 5e9/L. This date could then be taken as an "effective diagnosis date". EDD for those who like acronyms. <BR/><BR/>Its not perfect, as doubling times are not always constant, but it would make a first order correction. <BR/><BR/>Or is this done already?Anonymousnoreply@blogger.com