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1.3 log increase on dasatinib after mr4.5

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Hello everyone,

I was hoping to ask for your opinion... i am 33 yo, and have been undergoing treatment with 100mg dasatinib for the past 2 years. My cml was noticed quite early. Everything went smoothly for the past 2 years, my BCR-ABL nicely decreased (there were some fluctuations here and there but not significant), I achieved MR4.5 after a year, and for the most part of my 2nd year i was keeping it (in and out, fluctuating between MR4 and 4.5). I was trying to improve my health, lost 15kg with keto diet, and i have been taking curcumin and d3 supplements.

... and then out of the blue here comes my latest results with a 1.3 log increase that pushes me back to MMR; my bcr-abl went from 0.0016 to 0.0333 within 2 months (thats a 20x increase, 1.3 log). That feels like a huge jump in no so much time, especially that there was only 2 months between the tests and not 3 as the usual protocol calls for. 

Of course my doctor tries to make me feel calm about it, but thats pretty hard as you can imagine. I can't really name any reasons for this, my dasatinib dose was not changed, i am compliant to the minute, i am using the same lab to test my results, and there was enough blood cells in the sample; i did have a CT scan and a rather brutal food poisoning lasting 3 days though, but i wouldn't imagine that affecting my bcr-abl. Have you seen anything like this? Any ideas what should i do? 

Wish me luck, and thanks in advance!

---Thomas

 

Hi Thomas, there are a few posts a year like yours where PCR results seem to take a big jump. Many of them prove to be an anomaly in the test process and the next result goes back to the previous level. Has your doctor taken another sample for a repeat test? You are still in MMR at .03%. While I understand your concern try not to worry. If the result is confirmed in your next test, or a further increase is reported, it may be time for mutation testing. There are several other TKIs out there if for some reason dasatinib is no longer right for you, but you are a long way yet from having look at them.

Hi Thomas, you had an infection that could do it .I have had an infection twice ,an infected insect bite and a scratch on my ankle from a bramble.I left them for a few days to see if they would get better but needed antibiotics in the end and my bloods shot up .My doctor said this doesn't happen but my next blood test had gone down to below where it was before infection.So it can happen .Regards ,Denise.