Hello there,
You're definitely not alone in your early days' struggles with the undesirable effects of your new diagnosis and TKI treatment.
As Scubas has explained, it will take a good several months from diagnosis for your blood tallies to normalize. Now that your bone marrow become less crowded it can now begin to crank up normal myeloid blood cells to fill out the missing numbers.
But in the meantime, to address your low hemoglobin and mend your energy levels, you can help your bone marrow producing healthy mature red blood cells by opting for iron, B12 and folate rich food groups. It is equally important to remember that anemia can arise from simply not having enough of these vitamin and mineral levels in the body.
Hence, to isolate your low hemoglobin issue from a possible myelosuppressive condition inherent to dasatinib therapy, i'd suggest speaking to your doctor to get tested to find other underlying cause for your anemia.
Then again, as with all things new, TKI therapy included, maybe all that was needed is a little time for your body to adjust. But as to how much time is needed, only you can decide primarily for yourself basing your evaluation on how much of your quality of life has been affected by your treatment.
Personally, my own blood counts were like Korean horror films at the start of treatment. Particularly my neutrophils count. Merely a week into nilotinib regimen i was told to stay home for a week because my doctor fear that i might not survive the simplest strain of a flu virus. Though my platelets were just below the normal range it deemed clinically safe as long as i don't decide to take up fencing as a new hobbie. As for my hemoglobin, the count hit its lowest at 68 within a week also on nilotinib. Alarmed, my hematologist suggest that i check into the hospital for a blood transfusion to temporarily treat my anemia. But to that i politely refused because i had my own concerns with the associated pathological risks it involved. Next, my doctor opted that i get treated with an iron infusion which again i declined due to the possible side effects.
But the difference in our situations is that, at the time when my hemoglobin suffered, i never had the fatigue or fare badly in my daily activities. From memory, it was a week and half after my diagnosis and treatment commencement, i was back on board meetings without any problems at all.
For me, it did help that i took quickly to dietary change to overcome my anemia. For example i religiously turned to iron-food, such as leafy asian greens, b12 from ocean-caught fatty fish (greasy mackerels and sardines) and folate from lentil and spinach soup. Suffice to say that the forced dietary change show much improvement in my overall blood results, particularly my hemoglobin which continued to climb and to my latest blood test completed three days ago, persisted at 140.
Back to your situation, considering how very new you are in your diagnosis (not that I'm that far off in my own journey!), i would suggest to give your bone marrow another month or two to do what it must. And importantly, try to keep an open dialogue with your treating doctor about your overall concerns relative to your current treatment. Also be assured that part of the tki therapy's assessment of its efficacy and safety profiles is in ensuring that the patients' intolerability of the drug is kept to minimal. Besides, given the various TKIs currently available to treat CML, there bound to be one from the mix that will be slightly better for you then the rest.
I wish you the best of health in your journey with CML.
Best Regards,
Ellie.