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Sprycel : Could it cause changes in Ph- cells?


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#1 scuba

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Posted 10 May 2012 - 08:32 AM

I have been pleased with my Sprycel response and take Curcumin and all that, however:

http://www.journals....0059-2/abstract

"Despite the recent success of tyrosine kinase inhibitors (TKIs) in the treatment of chronic myeloid leukemia (CML), approximately 2-17% of patients develop clonal cytogenetic changes in the Philadelphia-negative (Ph?) cell population. A fraction of these patients, in particular those displaying trisomy 8 or monosomy 7, are at risk of developing a myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML)."

I did develop cytogenetic changes in my normal cells (non-Philadelphia + cells) along the lines described in this paper - specifically trisomy 8 and Monosomy7 at my last bone marrow (Dec 2011). Dr. Cortes tells me the risk of developing MDS is small but not zero and that "we watch" (which means more bone marrows despite my MMR). I do wonder what causes this - either the Sprycel itself or just a defective blood system. My CBC does show persistent anemia (25% less red blood). I don't know if they see this with Gleevec patients.

So even though Sprycel has been a great addition to the TKI mix, there is still a lot not known in comparison to Gleevec. It simply has not been in use as long. I would love to learn if there is any research to the contrary regarding Sprycel and cytogenetic effects on Ph- cells.

Anyone else have trisomy8 or Monosomy7 in their bone marrow reports? (especially anyone taking Sprycel?)


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"


#2 scuba

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Posted 10 May 2012 - 08:42 AM

http://www.mendeley....oid-leukemia-2/

Here is another paper specific to Gleevec and Monosomy7. The risk is very low (of developing MDS/AML), but does seem to be associated with patients who have persistent cytopenias (low blood counts) during TKI treatment.

My interpretation is that for those who have normal blood counts and are doing well using TKI's - this is a non-issue. But for those who have persistent low counts while on a TKI and having to take reduced dose because of it, this may be something to watch - especially if a bone marrow result shows the Trisomy8 and Monosomy7 clone.


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"


#3 idahobeavers

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Posted 10 May 2012 - 08:55 AM

ok that is what is going on with me! i have the trisonomy 8 and i have been on all 3 tkis currently on sprycel. i started showing mds on gleevec,still had it on tasigna and now on sprycel. we r watching it and i might have to have a bmt. scares the hell out of me



#4 scuba

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Posted 10 May 2012 - 09:10 AM

Hi Sarah,

What did your doctor mean by "watching it"? Do they think it can go away on its own?


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"


#5 Trey

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Posted 10 May 2012 - 09:12 AM

I know of several who have developed Monosomy 7 and/or Trisomy 8 in the non-leukemic cells during Gleevec therapy.  I do not know of any of those who transformed to MDS.  Although MDS can include one or both of these issues, it has other features that are the predominant causes of MDS, with -7 or +8 being a secondary issue.  With TKI therapy, often the -7 and +8 are transient and go away over time, which has led some to conclude that it is actually caused by TKI therapy, and therefore not significant.  As with many such issues, there is not enough data to make a definite conclusion either way.  But given the high overall success rate and the very low rate of loss of Sprycel response, if a person makes it through approximately 2 years and is CCyR or better, especially after MMR, the chances of transformation from any cause becomes very low.

We have discussed Sarah's case here:

http://community.lls.org/thread/13027



#6 scuba

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Posted 10 May 2012 - 09:35 AM

Thanks Trey - this has been a 'nagging' issue for me since Monosomy7 & Trisomy 8 have shown up and my counts are still somewhat suppressed (cytopenia).


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"


#7 idahobeavers

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Posted 10 May 2012 - 04:25 PM

hey scuba, what i should of said is they want a bmb every 3-6 mos and full blood work monthly and if there is a even slight change i have to get my butt to portland. and i have also talked witso i guess i reh dr.maurio at ohsu and he is in agreement with the other 6 onc/hemo drs plus the specialist i seen at ohsu. so i guess i really do have cml+ph and mds. bummer






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