After having a BCR-ABL around .02% for the last 3 years my last test through the hematologist three months ago had a blip up to .06%. Normally I wouldn’t let this phase me as I know it’s the nature of cml but during a routine blood test with my family physician a month ago my white blood cell count was 7.1 up from my 6 year average of 4.5 - 5. Again I understand this is within normal range but still trending higher from where I normally sit.
I’ve been on imatinib for 6 years with minimal side effects but since I’m 37 I was hoping to be on it as long as possible before resistance since I know I need to prolong my TKI options given my age and I’m hoping for a long healthy life span.
A few questions just so I'm well educated going into my appointment in a week. I know this could be an over reaction and I'm still hoping for a lower number, but if my BCR-ABL is significantly higher I want to know what to ask for.
1) Would dasatinib be the next logical TKI and should I ask for a starting dose of 50mg instead of the more outdated initial dosage of 100mg?
2) Do you think my long term prognosis is still positive having to switch TKIs already only being 37? I worry about running out of options if resistance keeps happening.