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Nilotnib : Dose reduction

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Hi all,

It's been an year I started off with Nilotnib 400mg BD. My PCr as of 26th Dec 19 - 0.00555

I have appointment with my Doc tom. Can I ask for dose reduction?

My lmyphocytes and esinophils are bit high almost since a month. Not sure why? Any thoughts?

Today's report
Total Leukocyte Count (TLC) 8.82 thou/mm3 4.00 - 10.00
Differential Leucocyte Count (DLC)
Segmented Neutrophils 43.00 % 40.00 - 80.00
Lymphocytes 41.00 % 20.00 - 40.00
Monocytes 6.10 % 2.00 - 10.00
Eosinophils 9.00 % 1.00 - 6.00
Basophils 0.90 % <2.00
Absolute Leucocyte Count
Neutrophils 3.79 thou/mm3 2.00 - 7.00
Lymphocytes 3.62 thou/mm3 1.00 - 3.00
Monocytes 0.54 thou/mm3 0.20 - 1.00
Eosinophils 0.79 thou/mm3 0.02 - 0.50
Basophils 0.08 thou/mm3 0.01 - 0.10
Platelet Count 204.0 thou/mm3 150.00 - 450.00

Kindly suggest

Hi,

I wouldn't be concerned about slightly raised levels of white cells. Our bodies produce more of these when we need to fight infections, and around this time of year (in the northern hemisphere anyway) mild illness is really common which can cause these small spikes.

Rather than just reducing your dose, you could talk to your doctor about some of the results from the NILO-RED study. There's a bit of an overview of the relevant piece below ... but in short, the observation was that patients who are doing well on nilotinib (and you sure are!) are frequently able to drop to a once a day dose regime with no adverse impact on their response. The primary reason patients wanted to do this was convenience (i.e. avoid fasting).

https://www.cancertherapyadvisor.com/home/cancer-topics/chronic-myeloid-...

How long have you been in that MR4 territory?

David.

Helo,

after 1 year and 10 months of tasigna (on 12 december) because of side effects like constipation, prostatitis and tinitus, i reduce my dose to in half, and after a week i stayed 3 days free of medicine, without my doctor approval, ho was against,( and recomendet me to make a colonoscopi for constipation, urografi for prostatitis), i mange to have normal stools and urinary jet have normal presion( i felt greate), then i started again with half doze, and because felt so good i went to gym the first time in tree months, although before prostatitis apear was a regular, after 2 sesion of training, my prostate felt like burning, and i am not fully recovered not even now, i am convinced that its tasigna its affecting my prostate, ho its a muscle organ, and  tasigna affect mucles, after this experience i spoke with my doctor and said to me that its not posible.

I am in MMR for 4 years, and my last PCR was 0,019, i will continue with half doze, butt once a day now.

From couple of months i have tried to convince my doctor to switch to dasatinib, i have told him about the study with 50 mg dasatinib, he knew nothing about that, although it assures me that is curent with all the news,butt he knew nothing about fathering a child on treatment,i convince him after i send the links from  David.

Its normal for my to change this doctor, butt its hard to do that  with a doctor in the same hospital, because him its a senior doctor, and have influence, i will have to change the hospital, butt if this happen, i will have to change my medical insurence hause and that its a risck that i cannot afford, i am trapped... 

Thanks David. Last 9 months I am in mr4