CML_Gleevec_CBC_Results.zip 8.28KB 8 downloads
This is going to be a bit lengthy post. Please bear with me.
My Father-in-law (60 yr old) was diagnosed CML in 2000. Gleevec was not available for him for first 3 years. He started Gleevec in 2003 and has been on 400 mg (200 mg twice a day. He is comfortable like that) all this while. Had to go up to 600 mg very few times and that too for a short periods. He even took many short breaks during his 11+ years of Gleevec.
All of a sudden, he started with mild cough which turned severe in a week. Started feeling very anemic and shortness of breath and CBC revealed following results
The low RBC explains cough, anemia and shortness of breath.
He is admitted to ER and 4 units of blood was transfused. During this chaos, one potion of Gleevec was missed and he took only 200 mg that day.
After that, CBC showed below results
Onc said it seems to be in accelerated stage and Gleevec might not be working for him anymore. He asked us to switch to Sprycel. We said it would take 6-7 days for us to procure Sprycel (there are reasons for this. Its altogether a different topic. Will tell if anyone is interested). Onc was OK with that and meanwhile he increased Gleevec to 600mg.
CBC is being done everyday since then and all blood counts (WBC, RBC, Hgb, PLT) are dropping consistently. Here is a snapshot.
Note - On second CBC counts column below, RBC and Hgb went up because another unit of blood was transfused. After that there was a steady decline
My questions :
1) Does all these CBCs suggest if the disease has progressed to Accelerated phase ?
2) Why is RBC (inherently Hgb) and PLT dropping everyday ?
3) Is the increase in Gleevec from 400 to 600 cause for this low numbers ? Or it would have happened anyway ?
4) Does decreasing Gleevec dosage to 400 or even 300 will help ? Or is it better to stop it until the numbers reach low normal ?
5) Does switching to Sprycel help ? Onc says start Sprycel 100 mg. Isn't it too high a dosage considering his blood counts ?
6) If at all he has to switch to Sprycel and just in case it doesn't work, can he go back to good old Gleevec ?
Onc has ordered for chromosome and mutation tests. Will get the results in a couple of days.
7) Is it good to wait on Sprycel until these test results come ?
I have attached a spreadsheet inside the zip file with all the above numbers with dates and events/actions.
This forum has been a great source of quality information. I am sure I will be advised the right thing