Posted 27 September 2013 - 10:35 PM
There are lots of factors that affect how much of the TKIs gets to the leukemic cells. Whilst blood volume probably plays a role it seems to be just a small role. At 5 ft 10" 120lb female I felt sure I would need less drug than average but when I was on 600mg glivec the trough concentration of the drug in my blood was less than average for people taking 400mg. Interestingly I still reached PCRU in 12 months.. Dosing seems to be start with what is known to be effective/safe and then suck it and see....although it tastes sooo disgusting I wouldn't recommend actually doing this. My docs approach was we can start you on 400 and see if you are able to/ need to go up or we can start you on 600 and see if you need to decrease. I chose 600 to optimise response (2nd gen drugs were not available).
Dx Dec 2010 @37
2x IVF egg collection
Glivec 600 & 800mg
PCRU March 2012
Unsuccessful pregnancy attempt - relapsed, 3 months interferon (intron A), bad side effects from interferon
Nilotinib 600mg Oct 2012
PCRU April 2013, 2 years MR4.5 mostly PCRU with a few blips
April 2015 stopped again for pregnancy attempt (donor egg), pregnant first transfer, 0.110 at 10wks, 2.1 at 14wks, 4.2 at 16wks, started interferon, slow dose increase to 25MIU per wk, at full dose PCR< 1 for remainder of pregnancy
Healthy baby girl Jan 2016, breastfed one month
Nilotinib 600mg Feb 2016
MMR May 2016
PCRU Feb 2017