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TKI Number 3

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#1 akjones


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Posted 21 February 2012 - 11:11 AM

Well it's onto drug number three. I've been on Gleevec for about 1 year, then Tasigna for about 1 year. Starting Sprycell tomorrow. My response has been good but not great to the first two TKIs, getting my bcr/abl down about 2 logs but never approaching the 3 log reduction level. I liked Tasigna much more than Gleevec as I had more energy and milder side effects. But have to admit the fasting requirements were a real pain at times. Had my genetics tested and no mutations so that isn't the issue. Regular blood work is great.

So it's not real clear why I have not been able to get the three log reduction. My personal suspicion is either: 1. I'm a long distance runner and I run about 50 miles a week, could this been effecting my response? Stopping running is not really an experiment I want to conduct just yet. 2. I'm still being exposed to whatever caused my CML, hard to pin this down as I am not exposed to any chemical as part of my work. I fly a lot, could this radiation be the source? Or perhaps the Ohio river water is the problem?

These questions certainly don't keep me up at night but are something I think about once in a while. Overall I am very thankful for these drugs and I am hopeful the third is the charm. Looking for any one else who is, or was, in my situation and insights you might have.

#2 Happycat


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Posted 21 February 2012 - 11:49 AM


Doubt those could be causes for lack of response. Could be efflux. Some people have cellular machinery that just pushes the drug right back out of the cell. We all have it just more active in some.

Or could be your cml uses more than tk pathway. Sprycel inhibits src kinase pathway, too, so that may do the trick for you. Not sure if that src pathway shows up on mutation test. What about amplification?  When you get dimer of bcr abl?  Fish would show that.


#3 LivingWellWithCML


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Posted 21 February 2012 - 01:39 PM

I'm a distance runner as well and I don't believe that's a factor at all.  If anything, I believe it helps by making our RBCs stronger.  I'm still anemic on Gleevec, yet I'm running 10Ks in ~ 44 minutes ... not bad for lower hemoglobin levels.

BTW, your weekly mileage is impressive - keep it up!  And best of luck on Sprycel - if I was a betting man, I'd say that it'll do the trick...

Dan - Atlanta, GA

CML CP Diagnosed March 2011

Gleevec 400mg

#4 Trey


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Posted 21 February 2012 - 06:31 PM

Since Sprycel is the most different of the CML drugs there is a very good chance it could work better for you, given that you are responding to the TKI drugs, just not quickly.

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