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Starting CML Treatment with "normal" WBC

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#1 rmerikle



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Posted 24 July 2014 - 04:17 PM

Newely diagnoised and on a steep learning curve. It would seem that most when they start treatment for CML have WBC in the hundred thousands. While my wife's are not normal they are bearly over 100. When starting Gleevec or a similar drug is there a concern that here WBC will drop to low? Or is the huge drop in WBC that I read about in others is due to the fact that they just started with such high counts?

#2 Shara



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Posted 24 July 2014 - 06:02 PM

I haven't heard that low counts while taking CML medication is due to your starting point. I started around the same white blood count as your wife and I never dropped below 4 which is the base for normal. I know several on this board that started around the 100,000 blood count and dropped below normal. It all depends on how her body is going to react to the medication. There are so many different factors that it is hard to tell how one might react.

#3 gerry


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Posted 24 July 2014 - 07:55 PM

I started with normal WBC and they continued to remain in the normal range whilst on Gleevec.

#4 Trey


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Posted 24 July 2014 - 08:28 PM

Her 100K WBC is probably close to average at diagnosis.  There is no way to predict who will have such a steep drop in WBC as to require drug breaks.  But women tend to have this occur more than men.  Just DO NOT let them give her Hydroxyurea, or she will very likely have a WBC crash after starting the TKI drug.  The only drugs should be the TKI (Gleevec) and Allopurinol (just for a couple weeks).

#5 Pin


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Posted 24 July 2014 - 08:58 PM

Just to clarify - a 100 WBC count means 100,000 (or 100K) (they just drop the extra zeros for ease of interpretation), so this is actually a high white cell count (normal is somewhere around 4-11 thousand). As Trey says, this is similar to most of us here, I was diagnosed with around 137,000 or so WBC count.

Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).

Commenced monthly testing when MR4.0 lost during 2012.


2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)

2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)

2015: <0.01, <0.01, <0.01, 0.013

2014: PCRU, <0.01, <0.01, <0.01, <0.01

2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01 

2012: <0.01, <0.01, 0.013, 0.032, 0.021

2011: 38.00, 12.00, 0.14

#6 pammartin


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Posted 24 July 2014 - 10:49 PM

When I began my treatment, my white count was normal.  As Trey noted, adding the Hydroxyurea with Sprycel caused a crash of my total system that took months to recover from.  Some people have fairly regular WBC and instead platelets skyrocket, as in my case. 

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