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Goodbye TKI


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#1 story

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Posted 29 July 2015 - 01:16 PM

Have some good news, I am in the LAST study and have been off the Tas for a month now, Just got the PCR results for my first month and it is negative, I am assuming that is PCRU. Don't want to get too optimistic but wanted to share the news with people that understand what it means. Had a lot of headaches and muscle and joint pain. Dont know if they are related to dropping the TKI or not. I really felt bad the first few months on Tas so I guess it makes sense I would feel something without it. My energy level and mental outlook are much better though.



#2 pammartin

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Posted 29 July 2015 - 01:32 PM

Congrats!  May you continue to receive those undetectable results.  Glad your energy and general outlook is better.  :)



#3 mikefromillinois

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Posted 29 July 2015 - 01:48 PM

Congrats story!  I'm at 2 months in the LAST trial and also still negative.  I think if we make it to about 6 months our odds will become very good for a happy ending.  Stay the course...



#4 tazdad08

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Posted 29 July 2015 - 03:15 PM

Good luck, and keep praying. I was on a very low dose (600 mg per week) for 2 years. I became detectable for the first time last month. That news hit me harder than the initial diagnosis. Stay strong and enjoy the better quality of life. Hopefully you will have long periods of time with no TKI's


Diagnosed in September 2011. Tried one year of Sprycel. Had great response. Became undetectable in a few months. Changed to Tasigna hoping for less side effects. Self medicated myself down to 20% dose and held for 3 years before becoming detectable again. It has been a journey that has helped me realize what life is about! I am all about a balanced life. I firmly agree with my decision to lower my dose. What is life if you aren't living? Mine will never be the way it was, but it is going to be as good as I can make it! Drs PRACTICE medicine, we can guide our dr to help us with a better life! Don't settle until it's acceptable to you!


#5 scuba

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Posted 29 July 2015 - 04:28 PM

All the best - take it one month at a time. The first six months are key. If you remain MMR/PCRU during those first six months - you have an excellent chance to go the distance. 


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"


#6 gerry

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Posted 29 July 2015 - 07:25 PM

Good luck. :)



#7 story

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Posted 30 July 2015 - 10:03 PM

Thanks for the thoughts and prayers, it is really helpful to be able to discuss with folks that understand.

#8 gerry

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Posted 30 July 2015 - 11:19 PM

It took about 18 months before I felt all TKI related side effects finally left.

 

I asked my doc if I ever could consider myself cured (maybe at 10 years) he just smiled at me. He has a patient who had a BMT 14 years ago and still has the occassional blip.



#9 Billie Murawski

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Posted 31 July 2015 - 02:08 AM

Wonderful Wonderful news I sure hope all our newbes read these posts and realize these meds do work. Billie



#10 SUE

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Posted 31 July 2015 - 09:24 AM

Congratulations, story.   Please keep us posted.


Dx  April 2013, FISH 62,  BMB not enough for PCR test; put on Gleevec 400;

 August 2013, FISH 8.7;

Oct 2013, FISH 5.6

Stopped Gleevec Nov 2013 for 6 weeks due to terrible side effects; Jan 2014 started Sprycel 50mg;

Feb, 2014 PCR  6.8

May,2014  PCR   .149

Aug, 2014 PCR    .015

Nov. 2014 PCRU

March, 2016  went down to 40mg Sprycel

Oct. 2016   stopped Sprycel for a couple weeks due to concern about shortness of breath.  Echo showed mild PAH.

Nov 1 2016  resumed Sprycel 20 mg daily 

Dec 2016  PCRU

March 2017  PCR 0.020

May 2017     PCRU

Sept  2017   PCRU

Dec    2017  PCRU

 


#11 TeddyB

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Posted 31 July 2015 - 01:34 PM

It took about 18 months before I felt all TKI related side effects finally left.

 

I asked my doc if I ever could consider myself cured (maybe at 10 years) he just smiled at me. He has a patient who had a BMT 14 years ago and still has the occassional blip.

 

Wow, it hung in there for a long time, glad they left at last :)



#12 gerry

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Posted 31 July 2015 - 10:54 PM

Brain fog was the first thing that disappeared, skin issues was next. 

Funny thing is I was able to drop BP med and cholesterol med while on Gleevec, back on them now. lol



#13 Billie Murawski

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Posted 01 August 2015 - 02:14 AM

Hi gerry, Brain fog is my main complaint and I'm only on 20mgSprycel. I read the pamplets that come with my other meds a lot of them say confusion disorientation memory loss dizziness I'm afraid I'll get a dui the next time I walk into a grocery store. I.m afraid to drive anymore I try to tell my doctors but they all think I'm nutz! I need some mind exercises to help me concentrate better. Any Ideas, I should get a job or volunteer somewhere but I probably would forget where I'm supposed to go :wacko: . Billie                Have a good day

 

Obviously I still cant sleep, it's been a year now.PA says today maybe I need a sleeping pill, yeah right I really need another pill to take UGGH!!!!!!!



#14 AllTheseYears

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Posted 01 August 2015 - 10:40 AM

I'm happy to hear from participants in the LAST Study.  My onc has approved me to try to be a participant in the study at Duke Medical Center in N.C., but the study keeps being delayed there due to holdups in the computer training.  So frustrating!  Now set (allegedly) to start by mid-August. My problem is that I'm about out of Gleevec and am hesitant to buy more because I'll need to pay the entire Medicare coverage gap to get one month's Rx.  More than $8,000. Then, I might not need any more Gleevec for the year, after paying the "deductible." 

 

I'm tempted to "roll the dice" and see if I remain PCRU until the trail begins.  That also means, however, that I'll be off Gleevec until the 21-day follow-up lab to ensure I'm still PCRU.  BTW: I've been PCRU more than a decade now, maybe 11 years or so.  I'm thinking rolling the dice might be worth the gamble. 

 

Any thoughts?



#15 mikefromillinois

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Posted 01 August 2015 - 11:42 AM

Seems like there have been comments in this forum from people who had overstock or no longer needed Gleevec and were having a hard time "getting rid of it" because neither the pharmacy nor their doctor wanted to take it off their hands.  I think the person with the extra meds ended up soliciting private messages from anyone who needed some.  (There are probably rules/laws against giving it away hence the private message aspect).  Maybe someone here who has extra meds will see this and private message you.

 

Good luck at Duke.  We'll be rooting for you.  Please keep us updated.



#16 Buzzm1

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Posted 01 August 2015 - 12:16 PM

I'm happy to hear from participants in the LAST Study.  My onc has approved me to try to be a participant in the study at Duke Medical Center in N.C., but the study keeps being delayed there due to holdups in the computer training.  So frustrating!  Now set (allegedly) to start by mid-August. My problem is that I'm about out of Gleevec and am hesitant to buy more because I'll need to pay the entire Medicare coverage gap to get one month's Rx.  More than $8,000. Then, I might not need any more Gleevec for the year, after paying the "deductible." 

 

I'm tempted to "roll the dice" and see if I remain PCRU until the trail begins.  That also means, however, that I'll be off Gleevec until the 21-day follow-up lab to ensure I'm still PCRU.  BTW: I've been PCRU more than a decade now, maybe 11 years or so.  I'm thinking rolling the dice might be worth the gamble. 

 

Any thoughts?

roll the dice AllTheseYears .. if you can't hold PCRU for a couple of months without your daily dose of Gleevec, it isn't going to matter whether you are in the study, or not .. there are still 5 full months before the end of the year ... and a whole new Medicare "out of pocket expense .. donut hole" begins

 

PS: For 2016, the Medicare Donut Hole will be $3,310 to $4,850.

 

how is your Medicare Advantage drug coverage structured?

 

Mine is, no initial deductible, 25% of drug cost until the donut hole is reached, and $12/Tier 5 Rx in catastrophic phase.


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#17 Buzzm1

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Posted 01 August 2015 - 02:05 PM

Hi gerry, Brain fog is my main complaint and I'm only on 20mgSprycel. I read the pamplets that come with my other meds a lot of them say confusion disorientation memory loss dizziness I'm afraid I'll get a dui the next time I walk into a grocery store. I.m afraid to drive anymore I try to tell my doctors but they all think I'm nutz! I need some mind exercises to help me concentrate better. Any Ideas, I should get a job or volunteer somewhere but I probably would forget where I'm supposed to go :wacko: . Billie                Have a good day

 

Obviously I still cant sleep, it's been a year now.PA says today maybe I need a sleeping pill, yeah right I really need another pill to take UGGH!!!!!!!

Like you Billie, I'm not getting needed sleep .. feeling wired and after laying awake for an hour, or two, I usually end up getting out of bed and sitting on my computer for a few hours before being able to sleep for a few hours.  Wondering if it has anything to do with my recent TKI dosage reduction?  Remembering the early days of this illness when I would fall asleep in one minute, or less, and do it multiple times a day.  Lack of good sleep is rapidly taking a toll on my health and I'm hoping I get beyond this pdq.  Have lots on my mind, which is likely part of the problem, but probably not nearly as much as you do from what you have been saying.  


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#18 chriskuo

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Posted 01 August 2015 - 04:25 PM

If you are not getting enough sleep, see your doctor about prescription sleeping aids. If they get you on a normal cycle, after a short time, you may not need them on a continual basis. The better sleep will help you feel much better.

#19 Trey

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Posted 01 August 2015 - 04:41 PM

A-T-Y,

No real risk in stopping now or spread it out 200mg daily for as far as the current supply goes.



#20 gerry

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Posted 01 August 2015 - 05:19 PM

The only problem with stopping is that you're still not sure when the trial is going to start. My doc put me on two monthly testing rather than the usual 1 monthly testing, but you need to be a in shorter testing regime than you probably are now.

 

Trey's suggestion about dropping your dosage to 200mg is a good one. I wouldn't stop until you are on the trial. It is also better for their trial as they usually don't want anyone that has stepped outside the specifics for the trial.

 

The CML comes back at a fast rate in that first six months, so you're better to be taking some until you start the trial.

I asked my doc about the speed of the CML returning once past the six months, he told me it returns to the chronic phase speed.

 

One thing to keep in mind, we are never cured, I know of someone who has been off for nearly 10 years and is still getting very low levels of CML showing up.






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