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Sprycel Increased to 140mg


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#1 leejoshuajohn

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Posted 24 September 2014 - 04:43 PM

Hi Everybody, 

 

    So I am about 6 days into my increase of Sprycel (from 100 to 140) and I got a CBC today. My WBC, which usually hovers around 3.8-4.8 is down to 2.8 and my neutrophils which are usually about 2.5 are down to 1.5. My platelets are usually around 160 are down to 138. Is this normal for an increase of medication? Does anyone know if this will level off and rebound or am I going to be dealing with this long term??



#2 hannibellemo

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Posted 25 September 2014 - 08:06 AM

That's alot of Sprycel! I was trying to find in an earlier post if you mentioned why your doc decided that was the way to go when most of us are trying to reduce our dosage. To answer your question, though, I don't believe what you are experiencing is unusual, especially at that dose. 


Pat

 

"You can't change the direction of the wind but you can adjust your sails."

DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>


#3 pammartin

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Posted 25 September 2014 - 08:55 AM

I took 140 mg of Sprycel for a time. Your results are fairly close to mine were, when they pulled the 140 mg my platelets were close to 60,000 and my WBC was 1.9. I was also on Hydroxyurea (sp) and my body took quite a beating from the combination. I also had severe side effects from the increase of Sprycel from 100mg to 140mg. I am not sure of your history but please be careful. It took me several months to feel better and get back on my feet after my oncologist dropped the Sprycel back to 100mg. Take care
Pam

#4 leejoshuajohn

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Posted 25 September 2014 - 09:20 AM

Okay, So my CML history is such that I started on Tasigna and reached CCYR, but barely. I switched to Sprycel and experienced better PCR results, but not MMR. Since I am only 30 (dx four years ago) my onc wants a better PCR. I've been in stable CCYR for almost 3 years, but my onc isn't satisfied. He thinks that I metabolize the drug too quickly and that perhaps I need more drug. I have no idea if this is a good idea, but I guess we will see. 



#5 August1

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Posted 25 September 2014 - 10:09 AM

Hi,

I've been on Sprycel for about 1 year. I did see various CBC counts dip at different times, especially my WBC and ANC. I think this is pretty common with Sprycel. For me everything has stabilized and my counts are all normal currently but it needs to be monitored (like everything else with CML).

 

CCyR is a great place to be, but I hope the increase works for you and you continue on the path to MMR!

 

Take care,



#6 Trey

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Posted 25 September 2014 - 02:18 PM

Not surprised about the low counts.  That will likely continue for quite a while, but there is no way to know for certain.  This is why high doses are not always the best approach.  They can drive the blood counts so low that drug breaks are required.  I don't know if that will happen to you, since we are all different.  But it is better to stay on a steady dosage than go to a high dosage and have continual drug breaks. 



#7 scuba

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Posted 25 September 2014 - 02:49 PM

Not surprised about the low counts.  That will likely continue for quite a while, but there is no way to know for certain.  This is why high doses are not always the best approach.  They can drive the blood counts so low that drug breaks are required.  I don't know if that will happen to you, since we are all different.  But it is better to stay on a steady dosage than go to a high dosage and have continual drug breaks. 

 

Although - alternating with high/low dose could work. It did for me. I went 20mg / 40mg (following your suggestion by the way) for 3 months which broke the cycle of myelosuppression before returning to just 20mg and great response. Perhaps a 140 one day followed by 70 the next would enable blood counts to recover, but also keep added pressure on the CML. It's just a guessing game at this point. If I lose response (become "detected" again), I will probably go back to 20/40 and not just 20 alone.


Diagnosed 11 May 2011 (100% FiSH, 155% PCR)

with b2a2 BCR-ABL fusion transcript coding for the 210kDa BCR-ABL protein

 

Sprycel: 20 mg per day - taken at lights out with Quercetin and/or Magnesium Taurate

6-8 grams Curcumin C3 complex.

 

2015 PCR: < 0.01% (M.D. Anderson scale)

2016 PCR: < 0.01% (M.D. Anderson scale) 

March        2017 PCR:     0.01% (M.D. Anderson scale)

June          2017 PCR:     "undetected"

September 2017 PCR:     "undetected"


#8 Marnie

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Posted 25 September 2014 - 05:48 PM

Just be sure to monitor yourself for pleural effusion.  If your breathing feels/sounds at all funny, especially when you lay down, or bend over, talk to your doc about it.  If you get a chest x-ray, be sure to have a radiologist read the results.  My first p.e. was misdiagnosed as pneumonia.

 

Marnie






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