I had suboptimal response with Gleevec. My FISH levels dropped at first then went back to 100%. I switched to Sprycel and it had an immediate impact. Within a short time my FISH levels went to zero but not in the usual way. I could only stay on Sprycel 70mg for two weeks due to severe myelosuppression brought on by the Sprycel. I had to stop Sprycel (and not take any TKI) for 3 months while my blood counts recovered naturally (no stimulation of the bone marrow). During that time, however, my FISH continued to fall to zero even though I was off the drug*. My PCR, however, did not fall but remained around 55% (intl. scale) even increasing a small amount. After 3 months, I was re-started on Sprycel but at a much lower dose of 20mg. I was able to stay on the drug without interruption. My PCR began to fall quickly. After seven months I went from 55% to 0.12% PCR and then 3 months after that my PCR fell to 0.06% (Feb'12 data). Dr. Cortes tells me I am in Major Molecular Remission and he does not want to increase my dose even though I asked him to increase it. He told me "more is not better". So I continue to take 20mg. Sprycel.
The most important thing about these drugs is that your trend is downward for PCR and FISH = zero. And once you get a zero in your PCR readings ( .0) you have a very good prognosis. Add a few more zero's to the right of the decimal point - even better.
Chances are very good that:
1: Your husband does not have the t315i mutation (even if he did, there is a treatment for that)
2. Your husband will respond to either Sprycel or Tasigna very well.
Switch to Sprycel (or Tasigna) and measure response at 3 months. No real need for a mutation test until after you try one of these drugs.
Hope this is useful to you.
p.s. *When I switched to Sprycel at 70mg, I also began a Curcumin supplement regimen. Curcumin is an herb that interferes with CML cells ability to replicate and stay alive. It is possible, but no one knows with any certainty, that the Curcumin impacted the CML along with the Sprycel. There is some data on Colon Cancer that suggests Curcumin + Sprycel is more effective combined. I am pleased that I am able to stay on 20mg. Sprycel and still achieve a deep response. I have no side affects that I can feel as a result.
Diagnosed 11 May 2011 (100% FiSH, 155% PCR)
with b2a2 BCR-ABL fusion transcript coding for the 210kDa BCR-ABL protein
Sprycel: 20 mg per day - taken at lights out with Quercetin and/or Magnesium Taurate
6-8 grams Curcumin C3 complex.
2015 PCR: < 0.01% (M.D. Anderson scale)
2016 PCR: < 0.01% (M.D. Anderson scale)
March 2017 PCR: 0.01% (M.D. Anderson scale)
June 2017 PCR: "undetected"
September 2017 PCR: "undetected"