Any time a TKI dose is changed (increased), CBC should be taken more regularly to verify stability.
In my case, I had weekly CBC tests until the right dose was set and my blood counts stabilized.
Advice on Sprycel dosage for CML newbie
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, Oct 15 2017 04:56 PM
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#41
scuba
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Posted 12 January 2018 - 03:02 PM
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"
#42
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Posted 12 January 2018 - 03:09 PM
Thanks all and copy on recommendations for more frequent CBC.
I'm going to reach out to my Onc and request every two weeks until next PCR.
This two week idea is based on my experience to date and my intuition / instinct / gut about how I am doing.
Aug 1 -2017 DX as a result of annual physical. I had been feeling tired and out of breath, WBC 130,
Baseline PCR 100 IS
Aug 4 Start Dasatinib 100mg daily
Aug 30 Stop drug due to Myelosuppression, CBC counts too low
Sep 8 Resume drug. (Onc prescribed 100mg every other day even though 50mg was the new desired
dose, this tactic because I had coincidentally just received 30 tabs of 100mg.) This every other day regime continued through Nov 8.
Nov 3 PCR 35.96 IS
Nov 7 New Oncologist
Nov 9 Start taking Dasatinib 50mg daily
Nov 25 Bump up dose to 70mg daily
Nov 30 PCR 14.79 IS
Jan 4-2018 PCR 2.65 IS
#43
hannibellemo
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Posted 15 January 2018 - 03:35 PM
Riggered,
It was well over 6 years before any of my counts went back in the normal range. My platelets and RBC still fall in low normal or high slightly below normal. Therefore, I have adopted whatever they are as my new normal.
Because my local cancer center thought I had acute leukemia when they first saw my CBC back in 2008 I was sent to Mayo-Rochester for initial dx and treatment. My onc there said they didn't even think about platelets unless they fell into the 20's. Due to the nature of platelets (sticky) 99 can essentially be the same as 80 (or vice versa) because they are so damn difficult to count.
As has been said before, let PCR/FISH lead the way in these early days.
Good luck!
Pat
"You can't change the direction of the wind but you can adjust your sails."
DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>
#44
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Posted 15 January 2018 - 04:29 PM
I sent my onc an email last week asking about setting up CBC every other week and he replied back in 10 mins with approval and scheduling.
Thanks all for insight and support
Thanks all for insight and support
Aug 1 -2017 DX as a result of annual physical. I had been feeling tired and out of breath, WBC 130,
Baseline PCR 100 IS
Aug 4 Start Dasatinib 100mg daily
Aug 30 Stop drug due to Myelosuppression, CBC counts too low
Sep 8 Resume drug. (Onc prescribed 100mg every other day even though 50mg was the new desired
dose, this tactic because I had coincidentally just received 30 tabs of 100mg.) This every other day regime continued through Nov 8.
Nov 3 PCR 35.96 IS
Nov 7 New Oncologist
Nov 9 Start taking Dasatinib 50mg daily
Nov 25 Bump up dose to 70mg daily
Nov 30 PCR 14.79 IS
Jan 4-2018 PCR 2.65 IS
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