4 replies to this topic

[Lucas]

Hi, everyone. I just got my kariotype test from 7 mmonths and the result wasn't great. I'm still 40% pH+ so i think i'll havê to chance my tki. I have no mutations and i have some questions:
- if i havê no mutations what could cause my slow response?
- i'm lactose intolerant and know that second generation tki havê lactose. Does it afeccts the drug absorption?
- anybody in my situation out there?

Thanks in advance

[Trey]

Mutations in the kinase are only a relatively small part of poor response.  Other reasons include: 1) poor uptake from the digestive system, 2) poor uptake into the cells, 3) overexpression of other conflicting enzymes such as LYN, 4) "stronger" Philadelphia Chromosomes (sometimes doubled, sometimes variations in the breakpoint, sometimes just tougher for some odd reason)  or 4) a combination of these. 

 

You need to switch drugs.  The various drugs (one or more of them) can overcome most of the issue outlined above. 

 

The lactose issue is not relevant.

 

Many people have been in your situation and have done well after changing drugs.

Edited by Trey, 15 September 2014 - 08:48 PM.

[Lucas]

Thanks, trey. I have tha b3a2 breakpoint a only one pH chromossome. Is there anything i can do to improve obsorption? Next week i'll have an appointment and we'll decide if i'll take tasigna or sprycel. Fingers crossed!

[Trey]

The TKI drugs only work by getting inside the leukemic white blood cells.  They do not work from the plasma, or inside any other cells.  The various drugs are taken up into the white blood cells in different ways.  Gleevec requires the hOCT1 cell transport pump, and some people have weaker cell pumps by genetics.  Tasigna and Sprycel do not require the hOCT1 pump to get inside the white blood cells, so often they work better than Gleevec for this one simple reason.  It is probably the number one reason why Gleevec does not work well for some patients, but they do well on either Tasigna or Sprycel.

http://www.nature.co...l/6100268a.html

 

Either Tasigna or Sprycel would probably be a good choice.

[Lucas]

Thanks again (and again) trey! I hope that's my case. my doctor called me today and told me that he prefer to start me with tasigna. he thinks it less toxic in long term and told me that both (tasigna and sprycel) have 50% of cml free survival for imatinib resistant/failure patients, so the chances are good. he also told me that he doesn't think it's necessary a drug break before start tasigna (also told me that my low platelets are not caused by the therapy  response).

 

Cheers!