I have been on Sprycel 80 mg for about 2.5 years now for CML and have responded well.
Last fall I developed a persistent cough and shortness of breath with exertion. I went to urgent care and was found on CXR to have bilateral mild to moderate pleural effusions and bilateral lower lobe atelectasis, with possible underlying pneumonia. I was treated with 10 day course of Doxycycline in early DEC, which for the most part resolved the cough, but persistent bilateral pleural effusions were noted on follow up CT of chest after completion of the Doxy. In retrospect I was developing shortness of breath on exertion over last summer, but just thought I was out of shape. So, I could have had a pneumonia develop later in the fall, which responded to the Doxy, but I suspect the effusions were developing prior to that.
My oncologist took me off the Sprycel in mid DEC, after the CT findings. The shortness of breath on exertion has gradually improved, but a follow up CT five weeks later showed small right pleural effusion and small to moderate left pleural effusion, both decreased in size from the prior CT. Scattered areas of bilateral atelectasis in the lower lobes was also still present on the follow up CT.
The oncologist has made no mention of evaluating the effusions further, or of treating the effusions with a short course of steriods. Or of resuming Sprycel at a low dose. She just wants to switch me to generic Gleevec.
Should the effusions be evaluated further? How often should they be checked with CXR or CT? Does the effusion need to evaluated with a needle aspiration? I have Hashimotos, should I consider some kind of autoimmune component to the effusions? Or is this all just overkill?
Has anyone had experience with a short course of steroids before resuming Sprycel or is this overkill?
So the effusions are very gradually reducing in size and I am tolerating the residual shortness of breath, but when is a short course of steroids typically recommended?
Would my oncologist be offended if I asked her to consult with the folks at MD Anderson?
Any more thoughts greatly appreciated, Susan