7 replies to this topic

[mdszj]

In the past few weeks I have gotten a bit of a dry cough but I dont really think I am sick.  Otherwise I feel good.  My ankles seem to swell up a little more than usual recently, although this has never bothered me and still does not.  I also had a BNP test (B-type Natriuretic Peptide) test back in March and the result was 177 pg/mL.  Apparently anything over 100 pg/mL suggests possible congestive heart failure.  I am not sure whether these could all be related somehow.  It is not clear to me whether any lung issues are related to heart problems.  I have been on Sprycel 100 mg for a little over 3 years and have been PCRU since Oct 2013 (except for a minor blip that resolved back to PCRU).

 

Any info appreciated thx.

[Billie Murawski]

hi mdszj, You need to get a chest x-ray immediately, you might have a pleural effusion which is a common occurance with Sprycel. I've been on Sprycel 5 years now I was on 100mg for a couple years then I was getting very short of breath and went to the er, I was admitted and a few hours later they drained 2 liters of fluid from my lungs. I was in the hospital 5 days. Onc took me off Sprycel for 6 weeks it didn't affect my pcr at all, he also had me get a chest x-ray every month for six months, I think he started me back on 50mg for about a year and now I take 20mg a day and I have been undetectable for 5 years now. Now if I have any kind of symptoms at all he does a chest x-ray also I take a water pill every day, You shouldn't wait any longer to get checked out. The procedure isn't bad they gave me a happy pill beforehand and basically all you feel is pressure the important part is keeping yourself calm, the thought of what they are doing is much worse than than taking the fluid out and I felt much much better immediately.

 

                                                                                   Good Luck Billie

[DebDoodah22]

When you had this cough did you wheeze when lying down?

[Trey]

A high BNP test result along with swelling in the lower extremities can be signs of congestive heart failure, so that possibility cannot be ignored.  But you should also be tested for pericardial and pulmonary effusion, which is more than just fluid around the lungs, but also around the heart.  Sprycel can definitely cause this in some people.  Fluid around the heart puts pressure on the heart from the outside, restricts heart expansion while beating, and reduces blood flow while also making the heart work too hard.  This is obviously not good for the heart.  So this reduces blood flow to the lungs, which along with the fluid around the lungs results in restricted breathing and overall reduction of oxygen to the body.  I would suggest testing for pericardial and pulmonary effusion, and if found a break in Sprycel. 

 

http://www.mayoclini...ms/con-20034161

 

BNP can be elevated due to pericardial effusion:

http://www.scielo.br...arttext&tlng=en

[dede5]

Is the BNP test one of the routine tests that's done every 3 months? (I didn't see that on any of mine, but I'm not the best at reading them.) ...or do I have to get that from pcp?

[mdszj]

Thx to everybody that responded to the post.  Deb - no wheezing at any time that I could tell.  Trey and Billie - wow that is not the best news, do you know if it gets better if you stop or reduce the dosage of S?  ALso can you go back on the S, maybe at a reduced dose, after the pericardial and/or pleural effusions subside?  Not sure if 2 yrs undetectable is something to hang my hat on yet.  Dede5 - I got the BNP test when I went to see a myeloma specialist.  This past January I was also diagnosed with smoldering myeloma (precurser to myeloma) and that was one of the many tests they did to get a baseline snapshot.  As far as I know that is not a test for cml patients typically.

[Trey]

If it is pericardial and pleural effusion, a drug break can help reset the issue and a restart on lower dosage Sprycel would be possible.  But don't ignore the possibility that it is congestive heart failure.  Your docs need to do more testing.

[hannibellemo]

Dede5,

A BNP is not a test that would be normally done unless there is some suspicion of cardiac failure.