Myelosuppression: a good sign?

[Fishermangents]

Myelosuppression seems to be a returning discussion point, mostly in the context of an adverse side effect or toxicity. After the ASH investors meeting on 6 December, sdrawkcabeman, the best poster on YMB, commented the following:

"Everyone on that panel acknowledges all toxicities are predictably and completely manageable w/simple dose modulation. And I heard thunder when Dr. Burington relayed Dr. T’s comment RE Imet’s specificity; to paraphrase, considering Imet’s remarkable efficacy, Dr. T expected MORE myelosuppresion but instead saw LESS due to Imet’s clonal specificity, music to regulators’ ears."

It seems to be sufficiently proven that myelosuppression is manageable. Thanks to the lifting of the clinical hold we also know that LFT's are reverseable and that the FDA has been convinced of that.

In addition, almost on a side note, Dr. Baerlocher was asked about her interpretation of the myelosuppression/anemia, and she said something in the following line:
- mutant stem cells produce blood cells, just like the wild type stem cells
- imetelstat specifically targets the mutant stem cells
- if a patient has a high percentage of mutant clones, the myelosuppressive effect will be larger, which is in fact an indicator for efficacy
- while the mutant stem cells are being suppressed (and eradicated) by imetelstat, the healthy stem cells are repopulating the bone marrow, which results in restoration of the blood counts and resolving the myelosuppression

However, it seems that that myelosuppression is not only caused by suppressing the mutant stem cells. So I am wondering to what extent myelosuppression involves suppressed healthy stem cells compared to the suppression of the mutant stem cells. Answering this can say something about the adverse side effects of imetelstat (if any), as the suppression of the mutant stem cells is not what we should call an adverse (or toxic) side effect, but in fact just a good sign of efficacy. Presentations have not been clear about that as far as I can see.

Any opinions about that?