My husband was diagnosed in March (at age 32) with a WBC count of 317k. The next week they were up to 450k. They thought he might be in blast crisis but the BMB proved otherwise showing 2% blasts. His diagnosis was Chronic Phase CML. He was put on hydroxurea for 4 weeks and started 100mg Sprycel. The doc said Sprycel was stronger and she wanted him on that, so he went with it.
Immediately after starting the sprycel, his WBC, RBC and platelets crashed. (His Platelets at diagnosis were normal at 188) He was bordering on needing a transfusion with a HCT of 24. His platelets went as low as 50. WBC to 1.6 or so.
He was taken off Sprycel the first time with the doc saying that maybe it was the combo of Sprycel and the hydroxurea (which he had just stopped) and that he would tolerate the Sprycel better without the hydroxyurea. . We waited 2 weeks for his levels to normalize, they did, he restarted the Sprycel and his levels depressed again, although his RBC's were slightly low, but ok. It was mainly his WBC and Platelets.
Stopped the medication again, 3 weeks off and he has now restarted at 50mg. He's been on it for 1 week now... he has a doc appt tomorrow and we will see what his numbers are doing. My fingers are crossed that this dose isn't going to crash him.
He has not had a PCR or FISH since diagnosis, and i just looked at his BMB result and all it said: (not helpful)
|BCR_ABL SPECIMEN DESCRIPTION||BLOOD|
|BCR_ABL RESULT||SEE COMMENTS|
|BCR_ABL INTERP||SEE COMMENTS|
|BCR-ABL mRNA was detected.|
|BCR_ABL COMMENT||SEE COMMENTS|
|The size of the PCR product is consistent with the typical breakpoint|
seen in chronic myelogenous leukemia that results in production of
the p210BCR-ABL transforming protein.
|BCR_ABL CLINICAL INFO||SEE COMMENTS|
I'm thinking the actual results are in the comments, which are not on the lab results I can look at online. He's going to ask his doc about a repeat PCR/FISH tomorrow since he has spent more time off meds than on them.
Anyway, all that to ask my question: Do some people react like this to the medications and then continue on to eventually tolerate them? Will he build tolerance at the lower dose and then be able to slowly increase it? If he can't tolerate Sprycel at all and has to switch to something else, is there a chance he will even be able to tolerate those? He is very strong and healthy and I was just shocked that the magic pill knocked him on his ass like it did...
Thanks for your help!