Hi. I am still new to all this as I was just diagnosed last month on 3/26/2014 in chronic phase CML. Previously I tried taking the 100 mg Sprycel daily and then every other day and I still developed cytopenia. I saw my hem/onc Friday (4/26) after being off of 100 mg Sprycel for 10 days due to low counts, or as my doc calls it cytopenia. .
So, after ten days off my counts this week were WBC 2.1, HGB 10.3, ANC 1.0, Platelets 134 which is not a big step up from before the break but my platelets and hemoglobin levels came up a bit although they are still on the low end range.
Here is my concern. My onc wants to start me at 20 mg Sprycel this week because he has advised me that I am overly sensitive to the required 100 mg and even 50 mg so 20 mg seems like the best option right now. He also said that any type of shots of Nupogen to treat the nutropenia and boost white cell production would be out of the question considering I have CML and any type of boost of white blood cells is risky. Here are my questions:
1. Should I start the 20 mg this week even though my counts are so low already? Or should I ask my doc if we should hold off another week?
2. Has anybody had experience with this type of issue and what was the outcome? Or have experience taking a low dose of 20 mg Sprycel?
3.Will a lower dose of Sprycel (20 mg ) lead to disease progression or me not reaching my treatment milestones?
Any feedback is appreciated. Thanks, Jerry