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[duke01]

I am writing on behalf of my husband. He was diagnosed at age 50 with CML in chroinic phase and started on gleevac 400mg as most people do. He had slow response to this treatment his PCR moved from 79 to 40 in 6 months. During that time suffering with the typical muscle cramps. During this time taking protonix for acid reflux, which inhibits the absorption of TKI. At 7 months of treatment he started with weight loss and increasing fatigue to discover his PCR had risen to 84 with enough circulating blasts to have accelerated phase CML. He was switched to Sprycel 70 twice a day, which brought down his PCR to 0.3 over 4 months. He developed pleural effusions requiring drainage and dose was lowered to 70mg daily. He has maintained this dose for the last 10 months his PCR has stayed between 0.2 and 0.8 until last month moving to 1.2. He has had no further pleural effusions, mild muscle aches but mostly tolerating well. Doc suggests switching to Tasigna 400mg twice a day. We are leary to make another switch. Looking for feedback on possibly increasing Sprycel to 100mg or Tasigna at a lower dose?