Then that means patients are going to do well for a long period of time and possibly have a longer life than expected. The bigger the spleen, the worse the outcome for the patients: more symptoms, quality of life, and the body deteriorates. It’s not a nice picture.
If we accept that the goals of therapy are to improve the quality of life, and that the spleen should become as small as possible, then we want to make sure that’s the case and that it’s maintained small. And we also want to make sure that this is maintained over long time by repeating the testing every three to six months.
I’m trying to emphasize the objective measurements of the spleen, not just by saying, yes, it’s smaller, that’s good, but hey, can it be as small as possible?
We want it to be smaller; much, much smaller. And then once you have this result and it’s stable, we want to make it as stable as long as possible. If things are getting worse at a slow pace, that’s the time to intervene. You don’t want a complete loss over control of the disease and then say, now is the time to change.