Hello. I was diagnosed with CML on January 17, 2014. I was on gleevec for 1 month then moved to dasatinib. My CML is looking good for now. For about a year now I have had slowly increasing lymph gland/ node swelling on the left side of my neck. I had 1 needle biopsy done in February of 2016 then an excision in April of 2016, both inconclusive. I live in Tyler, Texas and decided on my own to seek help from MDAnderson in Houston, Texas. My petscan is clear except for the neck area. My bone marrow aspiration shows the CML in check and no signs of lymphoma as far as that can conclude. They want to do another biopsy on October 3 to further rule out lymphoma. I have asked them to consider the medicine as possibly causing my ongoing issues with this worsening neck swelling. Has anyone had to switch with success off of dasatinib due to this type side effect? My anxieties have increased although thus far the news hasn't been bad. My doctors at MDAnderson seem to want answers also as I have been told I would be the first and they have noted my question as to the dastinib being the source. Any help/guidance on this will be greatly appreciated. Thank You and God Bless. My prayers are with you all.
Sincerely ~ Philip N. Beam Sr.
Swelling lymph glangs on left side of neck possibly caused by Dastinib
Started by
PhilipBeamSr
, Sep 26 2016 12:56 PM
Dasatinib and lymph gland swe
8 replies to this topic
#2
Trey
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Posted 26 September 2016 - 02:25 PM
Sprycel (dasatinib) inhibits SRC kinases which Gleevec and Tasigna do not inhibit. Inhibiting SRC kinase can allow lymph WBCs (T-cells and NK-cells in particular) to become deregulated to some degree resulting in node swelling. It is often patient specific and somewhat rare. The deregulation can cause a reaction in lymph nodes where these lymph WBCs normally reside until they are needed. Often a drug break will allow the node to recede. If it does, that would show it was probably caused by the TKI drug and other testing would not be needed since the aspiration already showed it was not related to CML. If it were lymphoma it would usually be more widespread.
So a drug break would probably be a better approach than continued testing for other issues.
http://www.bloodjour...so-checked=true
#3
PhilipBeamSr
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Posted 26 September 2016 - 04:58 PM
@ Swelling lymph glands
#4
Red Cross Kirk
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Posted 26 September 2016 - 07:31 PM
Philip, perhaps a dasatinib dose reduction would help with the swollen lymph nodes? What was your last PCR result? Do you recall why you were changed from imatinib to dasatinib?
Kirk
9/25/2012 p210 transcript 118.7% IS @ Dx, begin Gleevec 400mg/day
12/2012 3.59% & bone marrow biopsy - no residual myeloproliferative features but detected 1/20 metaphases containing the Philadelphia chromosome
2013 0.914%, 0.434%, 0.412%
10/2013 0.360% & bone marrow biopsy - normal male karyotype with no evidence of a clonal cytogenetic abnormaltiy
2014 0.174%, 0.088%, 0.064%
2015 0.049%, decrease to Gleevec 200mg/day, 0.035%, 0.061%, 0.028%
2016 0.041%, 0.039%, 0.025%
2017 0.029%, 0.039%, switched to generic imatinib 200mg/day, 0.070%, 0.088%
2018 0.233%
#5
PhilipBeamSr
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Posted 26 September 2016 - 11:05 PM
The doctor changed me after 1 month I think just to advance me to dastinib. MDAnderson after my bone marrow aspiration 2 weeks ago said my CML is basically in remission. I will have to get the number, but it was something like .001, I think. I can as them per the portal. I really have only been on dasatinib and for the most part 100mg/day. My WBC in the beginning was around 170,000.
#6
Red Cross Kirk
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Posted 26 September 2016 - 11:39 PM
If you have such a low level of leukemia now, you should probably talk to your doctor about lowering your dose or changing to a different TKI. I believe Scuba consults with Dr. Cortes at MD Anderson and is currently on 20mg per day and is soon to be reducing to 10mg per day.
The article Trey pointed out says that most of the people diagnosed with dasatinib induced follicular lymphoid hyperplasia were switched to nilotinib It's something worth discussing with your doc.
Kirk
9/25/2012 p210 transcript 118.7% IS @ Dx, begin Gleevec 400mg/day
12/2012 3.59% & bone marrow biopsy - no residual myeloproliferative features but detected 1/20 metaphases containing the Philadelphia chromosome
2013 0.914%, 0.434%, 0.412%
10/2013 0.360% & bone marrow biopsy - normal male karyotype with no evidence of a clonal cytogenetic abnormaltiy
2014 0.174%, 0.088%, 0.064%
2015 0.049%, decrease to Gleevec 200mg/day, 0.035%, 0.061%, 0.028%
2016 0.041%, 0.039%, 0.025%
2017 0.029%, 0.039%, switched to generic imatinib 200mg/day, 0.070%, 0.088%
2018 0.233%
#7
PhilipBeamSr
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Posted 26 September 2016 - 11:54 PM
Thank you very much. I have been confused abut the lymph node swelling. Dr. Naqvi was leaning toward a second biopsy before deciding to consider switching. She works with Dr. Cortez. That will mean a 4 hour ride from Tyler for a Head and Neck consult Friday then return Monday for an excisional biopsy.I went on my own accord to ENT in Tyler back in April and had my 1st biopsy. Texas Oncology was simply sitting on it. I then sought out MD Anderson about 1 month ago. My left neck has quite a bit of node swelling yet inconclusive thus far. Thank you for your help. I am still in a fog after 3 years.
#8
Gail's
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Posted 27 September 2016 - 03:49 AM
Phil, sorry to hear of your swollen nodes but I'm glad the CML responded so well to dasatinib. Do your swollen nodes feel painful or did you notice a lump in your neck?
Diagnosed 1/15/15
FISH 92%
BMB 9:22 translocation
1/19/15 began 400 mg gleevec
1/22/15 bcr 37.2 IS
2/6/15 bcr 12.5 IS
3/26/15 bcr 10.3 IS
6/29/15 bcr 7.5 IS
9/24/15 bcr 0.8 IS
1/4/16 bcr 0.3 IS
Started 100 mg dasatinib, mutation analysis negative
4/20/16 bcr 0.03 IS
8/8/16 bcr 0.007 IS
12/6/16 bcr 0.002 IS
Lowered dasatinib to 70 mg
4/10/17 bcr 0.001 IS
Lowered dasatinib to 50 mg
7/5/17 bcr 0.004 IS
8/10/17 bcr 0.001. Stopped TKI in prep for September surgery.
9/10/17 bcr 0.006
10/10/17 bcr 0.088
FISH 92%
BMB 9:22 translocation
1/19/15 began 400 mg gleevec
1/22/15 bcr 37.2 IS
2/6/15 bcr 12.5 IS
3/26/15 bcr 10.3 IS
6/29/15 bcr 7.5 IS
9/24/15 bcr 0.8 IS
1/4/16 bcr 0.3 IS
Started 100 mg dasatinib, mutation analysis negative
4/20/16 bcr 0.03 IS
8/8/16 bcr 0.007 IS
12/6/16 bcr 0.002 IS
Lowered dasatinib to 70 mg
4/10/17 bcr 0.001 IS
Lowered dasatinib to 50 mg
7/5/17 bcr 0.004 IS
8/10/17 bcr 0.001. Stopped TKI in prep for September surgery.
9/10/17 bcr 0.006
10/10/17 bcr 0.088
#9
SandyG353
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Posted 30 September 2016 - 02:49 PM
Hi. My daughter has a swollen lymph node in her chest in between her lungs. I already posted it, and Trey gave me a lot of information to look at. In any case, I wanted to let you know that I e-mailed Dr. Druker and asked him whether patients that have CML can develope lymphoma. His response was that he never had a patient with CML who developed lymphoma. So, that information should put your mind at rest.
Sandy
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