I know that others here have dealt with pancytopenia due to tki treatment; my question is when should I be concerned?
I was diagnosed a little over a year ago, and was on Gleevec 400mg until mid February when my PCR went from 6% to 46% in three months. I've switched to Sprycel 100mg, and have been on it for 9 weeks, but my blood counts keep dropping. Right now, platelets are at 48, hemoglobin at 8.9, wbc 3.7 and and anc is 1.0. How low is too low? I know that I'm anemic, and have been having headaches, occasional nausea, and am cold ALL of the time, but my PCR is still very high for being 1 year post diagnosis, at 27%.
I had no problems with pancytopenia on Gleevec. Occasionally my hemoglobin was borderline low, but all other counts were relatively good. Why now? I would think that after 13 months on a tki, my "good cells" would have stepped up to the plate and upped their production.
My onc seems mildly concerned, but said only that my platelets are still adequate above 20. I have to pay him his $60...oops, I mean see him again, in a week. He said that if my blood counts do not go up, we'll have to consider a drug break, but with my PCR still so high, I'd be reluctant to do that. Should I, instead, suggest a lower Sprycel dosage? Is it possible that a lower dosage would allow my counts to recover, without letting the Ph+ cells to get out of control again?