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Sprycel and steroid shots


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#1 SB3

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Posted 09 July 2013 - 09:50 AM

I want to warn anyone who is on Sprycel (and probably any of the other TKI drugs as well) to be very careful about getting a steroid shot. Six weeks ago, I got a steroid shot to treat what we thought was a bad case of poison ivy (but, in hindsight, was probably a bad rash due to Sprycel). Today, I am recovering from surgery after developing a serious bacterial infection as a direct result of that shot.

The area (my right lower hip) became infected within a few weeks after I received the shot. The doctors tried antibiotics and draining the area, but nothing worked. After I developed a fever last week, the doctor said the only way left to treat the infection was through surgery. I now have four sizable wounds in my lower hip that have to heal from the inside out. Basically, the infection became trapped under my skin and needed an "escape route." I am facing several weeks of recovery.

Sprycel is likely the culprit of why my body reacted so badly to the steroid shot. I am currently on a drug break -- I see my oncologist next week to determine where we go from here. All this is quite disturbing, particularly since I had reached PCRU in April for the first time.

Of course, I can't help but kick myself now for agreeing to the shot in the first place. I would not be where I am today if I had treated the rash differently. But I wanted to share my story in the hope that it will keep other CML patients from making the same mistake I did. I try to forget sometimes that I have CML but this has been a pretty tough reminder that this disease is with me whether I like it or not.



#2 CallMeLucky

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Posted 09 July 2013 - 10:50 AM

Why do you feel Sprycel is the likely culprit of the infection?  Have they indicated there is any issue with Sprycel and steroids?  A couple of weeks ago I had to take prednisone orally for allergic reaction and it didn't seem to be an issue with Sprycel.  I assume they injected you with something else.  Has Sprycel caused you to have low white blood count, specifically ANC?  I'm just trying to figure out how Sprycel could have been the issue.  It would almost seem that the more likely scenario is that the needle was dirty or they did not do a good job disinfecting the injection site before giving you the shot.  Note that I am not saying Sprycel is not the cause, I just can't see why it would be.

Hope you feel better soon....


Date  -  Lab  -  Scale  -  Drug  -  Dosage MG  - PCR
2010/Jul -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 1.2%
2010/Oct -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.25%
2010/Dec -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.367%
2011/Mar -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.0081%
2011/Jun -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2011/Sep -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.00084%
2011/Dec -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Mar -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.004%
2012/Jun -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Sep -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Dec -  MSKCC  -  Non-IS  -  Sprycel  - 100 - 0%
2013/Jan -  Quest  -  IS  -  Sprycel  -  50-60-70  - 0%
2013/Mar -  Quest  -  IS  -  Sprycel  -  60-70  - 0%
2013/Apr -  CUMC  -  Non-IS  -  Sprycel  - 50 - 0.036%
2013/May -  CUMC  -  Non-IS  -  Sprycel  - 50 - 0.046%
2013/Jun -  Genoptix  -  IS  -  Sprycel  - 50 - 0.0239%
2013/Jul -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0192%
2013/Jul -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0034%
2013/Oct -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0054%
2014/Jan -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0093%
2014/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0.013%
2014/Apr -  Genoptix  -  IS  -  Sprycel  - 100 - 0.0048%
2014/Jul -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2014/Nov -  Genoptix  -  IS  -  Sprycel  - 100 - 0.047%
2014/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0.0228%
2016/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Dec - Genoptix  -  IS  -  Sprycel  -  100 - 0%
 

 


#3 SB3

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Posted 09 July 2013 - 12:42 PM

You're right, of course. It's possible Sprycel has nothing to do with what happened. The needle could have been dirty or the injection site was not disinfected enough. But Sprycel does do weird things to your cell structure and perhaps my body had a weird reaction when Sprycel and the prednisone shot were mixed. I had two skin rashes a few weeks after receiving the shot -- those cleared up quickly once I went off Sprycel. I did take prednisone orally a year ago for poison ivy and had no problem. Sure wish I had done so again this time. As for my white blood count, it did dip when I first went on Sprycel 1 1/2 years ago but stabilized when the dosage was dropped to 80 mg. My WBC and ANC have been within the normal range ever since. The onc explained that the drug break is to help my body heal better -- these are sizable wounds and they don't want anything to interfere with the healing process.



#4 Teresabourgeois

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Posted 09 July 2013 - 01:41 PM

I have to agree with CallMeLucky's thought process.  When I was  accepted into a protocol study for Sprycel, I was given a rule book.  Steroids are on the list of medications that I could not  take while in this study.  However, after multiple incidents of f,uid build up in my lungs I was allowed to take steroids. The worry is that both meds lower white blood count.  I've even been allowed  to receive steroid hip injections for a torn labrial.  Ive been taking predisone for last year everyday.  I'm lucky to have a team if Dr.s that watch me closely.  I hope you get this infection in check quickly.



#5 CallMeLucky

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Posted 09 July 2013 - 04:21 PM

That is interesting about the steroid lowering the WBC.  After two days on prednisone my WBC was 10K.  My Dr said he was not surprised my count jumped up because "I was on prednisone".

As for the infection, who knows what does what.  I know Sprycel lists infection as a side effect but my understanding is that it goes together with low white count.  If white count is normal I did not think Sprycel would cause infection.  Everyone reacts different.  Hope you heal up quick and feel better soon.


Date  -  Lab  -  Scale  -  Drug  -  Dosage MG  - PCR
2010/Jul -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 1.2%
2010/Oct -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.25%
2010/Dec -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.367%
2011/Mar -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.0081%
2011/Jun -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2011/Sep -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.00084%
2011/Dec -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Mar -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.004%
2012/Jun -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Sep -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Dec -  MSKCC  -  Non-IS  -  Sprycel  - 100 - 0%
2013/Jan -  Quest  -  IS  -  Sprycel  -  50-60-70  - 0%
2013/Mar -  Quest  -  IS  -  Sprycel  -  60-70  - 0%
2013/Apr -  CUMC  -  Non-IS  -  Sprycel  - 50 - 0.036%
2013/May -  CUMC  -  Non-IS  -  Sprycel  - 50 - 0.046%
2013/Jun -  Genoptix  -  IS  -  Sprycel  - 50 - 0.0239%
2013/Jul -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0192%
2013/Jul -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0034%
2013/Oct -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0054%
2014/Jan -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0093%
2014/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0.013%
2014/Apr -  Genoptix  -  IS  -  Sprycel  - 100 - 0.0048%
2014/Jul -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2014/Nov -  Genoptix  -  IS  -  Sprycel  - 100 - 0.047%
2014/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0.0228%
2016/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Dec - Genoptix  -  IS  -  Sprycel  -  100 - 0%
 

 


#6 Teresabourgeois

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Posted 09 July 2013 - 05:48 PM

Your right CallMeLucky, I looked back to see why they wouldn't let me take roids.  Answer was that various drugs, including chemotherapy, have a dampening effect on the immune system. Corticosteroids, for example, are drugs that interfere with the inflammatory action of the immune system, and in reducing the immune response, indirectly reduce the ability of the immune response to defend against infection. It's more about the suppressed immune.  Sorry for that



#7 SunNsand

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Posted 09 July 2013 - 06:49 PM

I get 1 - 2 steroid shots a year and haven't had any problems with infection. (knock on wood)

SB3 - That sounds like a horrible ordeal you went through. I hope you recover quickly!



#8 Trey

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Posted 09 July 2013 - 07:39 PM

These intralesional steroids are known to cause subcutaneous necrosis as a side effect in rare cases.  Sometimes it is a lipid (fat) breakdown which may look like an infection, but is not.  I doubt it had anything to do with the Sprycel, but cannot say it is impossible.

http://www.dermnetnz...l-steroids.html

Depending on which steroid it was, there have been several recalls recently for bacteria contamination in them (including some used for skin issues):

http://wtkr.com/2013...oid-injections/



#9 Guest_billronm_*

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Posted 10 July 2013 - 11:20 PM

Hi SB3,

  I'm so sorry you had to go through such an ordeal. Sometimes we have horrible reactions to something and we never do find out what caused it. One day I got stung by a bee and had a terrible reaction (antyphalactic shock)  my throat was just starting to close up when the ambulance got here it was pretty scary I live in the country so it took a while for them to get here. I had been stung before and never had a problem. Now I always have an epi-pen handy, but I'm afraid to use it. I've been stung about 3 times since then and I didn't have any kind of reaction at all. The Dr. told me if I got stung again to give myself the shot right away and call the ambulance hell I'm more afraid of the shot than an allergic reaction to a bee sting. So now when I get stung I just sit down and wait to see if I start to feel weird, but I don't so I just put my cortisone creme on the sting and go on about my business. This happened years before my dx of cml. I figure in my case it was just a fluke. As Forrest Gump says S#%! happens.

  It is so odd that you brought up the subject of steroids right now. I have been on Sprycel for over 2/1/2 years and I have a problem with low iron. Two years ago I was receiving iron infusions and I had a reaction so they had to stop them, I tried 2 different kinds of iron pills and they made me sick so I have been tired all the time. I just finished up having another round of infusions, they gave me 2 tylonol,benydryl, and an iv bag of steroids it took about 20 minutes for the steroids to get in my system, then they gave me a different kind of an iron infusion it took about an hour, I had one treatment a week for four weeks with no problem. I just finished up my last treatment 2 weeks ago. I gained 10 pounds. I'm just now starting to deflate. I get bw next week so hopefully my iron level is going up. While this was going on I had surgery so I really don't know if my energy level is up yet hopefully I'll be bouncing around soon, and driving everyone on the board crazy again.                  Good Luck  Billie

ps, Rons platelets went up again, so he was on one side of the room getting phlebotomys, and I was on the other side of the room getting my infusions at the same time. What a Hoot!






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