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1st PCR test results on Sprycel after 14 weeks

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Just had my 1st PCR test.  Here is some history. 

Diagnosis  12/17/20     40.07

1st PCR    4/16/21       .1508

I started Sprycel 100mg on 1/1/21.   A quick disclaimer, I have missed some pills.  I would estimate that I have missed about 7 doses total since I have started.

My spleen has gone from 14 cm to 11 cm and my appetite has come back, however, I just went to the ER with abdominal pain due to an infection.  While my Dr. is very pleased with my results, I am concerned the 100mg might be to much.  I remember Scuba referencing some info that 50mg shows good, if not better results.  I do not know how these results compare to the expected outcome.  I am welcome to input and if anyone can find the thread or link to the 50mg vs 100mg Sprycel information, that would be GREATLY appreciated.

FF CML

 

Looks like you're having a really good response with dasatinib.  A lower dose would probably be a good idea.  Here's an article titled "Dasatinib Dose Management for the Treatment of Chronic Myeloid Leukemia".

https://sci-hub.se/10.1002/cncr.31232

A very good responsive for 3.5 months. And I think you’re right you could prob do with a dosage decrease seeing as you’ve responded so well. My spleen was 22cm below the margin which in my consultants words was “massive” that took just 6 weeks to return to normal size.

I would highly advocate not missing any doses if you can as those who miss doses increase the chances of progression and or resistant mutations. Sometimes this can’t be avoided though I know. But it’s best to avoid the mental torture you’ll give yourself too come testing time when you’ll kick yourself. I’ve only missed 1 of my 2 doses in 3 years but I know I’ll curse myself for any rises. Unlikely with missing the one off dose but best of avoiding it if you can.

Good luck with reducing dose

Al

Given your response, you should certainly consider lowering your dose. You might even consider 20 mg.

I didn’t know missing doses could cause mutations indecision   You have motivated me to do better. 

Good to hear!  I am going to talk to my oncologist at 6 months after my next PCR about it.  I feel the TKI causes damage elsewhere in my body, particularly in my abdominal area.  I don’t want to do something I can’t reverse. 

It’s resistance but you don’t want allow CML any chance to do what it wants. Adherence is really important but I do understand why sometimes it can’t be avoided. Also a lot of TKIs are hard on the gut especially in the early days mines much better now after 3 years.

Al