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Low platelet count on tasigna and bmb report..trey and company..please review

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#1 cpsn0000


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Posted 29 January 2011 - 09:33 AM

Well, I started Tasigna 150mg 2x per day on 1-1-11. Basically my Platelet count was at 339 on 1/7/11. Platlet count went to 404 on 1-12-11. Started 300mg per day on 1-9-11. Granted, I was off Gleevec again for 2 weeks to allow my platelts to recover again. They were at 138 on 12-23-10. On 1-18-11 my platelet count down to 227. On this past thursday, platelet count down to 75. Basically, all my other counts have been fine including my wbc count. I know platelet counts are affected in the beginning on some of us and was wondering how long does it take before this problem can subside? I read you can go through the start and stop to get through this problem..is this correct? If this doesn't work they are going to put me on Sprycel and if any problems continue, onto the clinical trial with Bosonutinb where that drug doesnt inhibit the C-Kit from producing platelets for your body while being on a TKI drug...

Trey and company, please give me your thoughts and feedback on this. I am re-starting tasigna on monday at 150mg 2x per day before going back up to standard dose..

Also, here is my BMB report from 12-23-10. Basically, I am still new to this game....I was on Gleevec starting 10/9/10 and was on until around 12/15/10. Also had a total of 4 weeks of from start to end date so not much time to make any real difference.


Blast BM 2.5%                                   Fish Shows 95.5 % 20/20 cells detected

Promycelote BM 2.0%                        The reticuloye count is normal. Granulocytes have normal maturation.

Mycelocyte BM 11.5%                        There is no overt increase in blasts on H&E and PAS stained sections

Metamycelote 12.0%.                             

Band Neutrophil 6.5%                         (These are some of the notes from BMB report shown directly above)

Segmeneted Neutrophil 4.0%

Eosinophil 0.0%

Monocytes BM 4.0%

Lymphocytes 7.5%

Plasmactyes 1.0%

Atypical Lymps BM 0.0%

Early Normoblast 2.5%

Late Normoblast 45.5 %

Megakaroyes Adequate Modified

M:E Ratio 0.9 Low

Any and all feedback would be nice...My doctor says I am firmly in chronic phase but need to be able to take some TKI drug before my being firmly in chronic changes because my body can withstand platelet reporduction while being on this medication..

#2 Trey


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Posted 30 January 2011 - 10:32 AM

As you have seen, a number of people here fight the low counts.  You will need to give the Tasigna a few weeks to see if things start to normalize.  If the only issue is low platelets, then that is not as bad as it could be if neutrophils were also very low.  You can always get platelet transfusions.

Your BMB shows essentially no drop in leukemia cells in the 3 1/2 months since diagnosis, probably due to being off drugs for the 4 weeks.  I would be more concerned about staying on the TKI drug at the highest tolerable dosage but balancing the low counts issue, and if it were me, I would take higher dosage and get the platelet transfusions.  Your primary need is to get the FISH/BMB leukemia counts heading lower.  The rest of the report looks OK, and it is good that your blast count remains low.  It mentions "Megakaryocytes Adequate Modified", which megakaryocytes are the pre-platelet cells.  The report that they were "adequate" at the time of the BMB is encouraging, so I would think you can work through this problem in a few months.  The platelets are often the last blood cell count issue to normalize.

#3 houtex54


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Posted 30 January 2011 - 11:14 AM

Tagging on to what Trey said - 

TKI drugs are not the only things that can contribute to low platelet counts. Some others are quinine (often used by people for help with leg cramp pain), antibiotics (cephalosporins, cipro, penicillins, sulfa-group, and others).  OTC and Rx anti-inflammatory and anlagesics (acetaminophen, ibuprophen, naproxen, salicylates - including aspirin).  Certain hypertension drugs, antidepressants, anti-histamines... a longish list can be found at -


Any of these in combination could be a problem, but one that could be managed if you let your doc know about everything you take in (and I mean EVERYTHING) from foods, to OTC meds, and dietary supplements.

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