Thought I would share my experience so far on Bosutinib since it's so new. Quick history...I'm trying this TKI as a last resort after the other 3 proved to cause severe myeloid suppression, especially neutropenia, that could only be managed with Nuepogen shots, etc. I wasn't able to keep enough drug in me to get a decent response so a SCT was being recommended by my local hem/onc. Did all the test and I have a good match, but thought I should try one final consultation and did with Dr Cortes at MD Anderson. It was concluded to go off all drugs (shots and TKI) until my numbers return to low normal (ANC at 1.0), then start on Bosutinib at 400 mg. (500 is standard dose) due to my sensitivity to TKI's. At week #5, after being off all drugs, my ANC were still .7, but my basophils had escalated to 20, so Dr Cortes said to get a shot and start the Bosutinib right away because the basophils were a concern.
Have to say that during this break, I had never felt better and was feeling better every day. So I was a little concerned about starting Bosutinib, but knew I needed to do something soon to try and control the basophils and CML. To my surprise, it's not been bad so far...just diarrhea and a few skin issues, which I'm hoping will abate soon. The good news is the surprising lab results after I started Bosutinib on the 14th and had one shot.
10/15 10/25 10/31 11/7 11/13 11/20 11/27
Wk #1 #2 #3 #4 #5 #6 #7
WBC 1.8 2.5 2.7 2.7 3.5 5.9 5.9
PLT 198 215 239 348 369 392 246
Baso 3 3 7 17 20 9 5
ANC .3 .4 .5 .5 .7 2.2 4.0
I originally thought my labs on the 20th might had been false...you know too good to be true, but then yesterdays were as good. I caught a bad cold over Thanksgiving from my beautiful baby grandson, but I'm already feeling better. I've never had this good of results even with shots, so I'm praying this trend continues and just wanted to share the good news and send encouragement to others, even though it's very early in this treatment plan. My past experience has always been my numbers tanking within a week or so, once starting a new TKI. Bosutinib could be a good alternative to help fight this disease. I'm so thankful and blessings to all! Melanie
