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HELP!! DR Wants bone marrow biopsy: Currently on Tasigna

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Hello All,

I am currently taking Tasigna 150 MG 3 times a day for a few months now. BCR is slowly coming down, however my Platelets have dropped for the last 3 months, as well as my WBC, ANC. I was originally on Imatinib and it caused my WBC and ANC to drop below to dangerous levels. Once I went back onto Imatinib but BCR didnt come down quick enough, so they switched me.

I expressed concerned about the same thing happening again, they said not to worry. DR says now they want to look at my bone marrow again for some reason, they are mainly concerned with platelets continuing to drop. I know side effects of tasigna is low blood levels including WBC and Platelets.

Dr wanted me to go on Sprycel but couldn't because of insurance and they wanted me to go onto Tasigna before.

 

Any advice or guidance is helpful. Kind of scared, not knowing why they want to look at my bone marrow again.

 

Can you be on a TKI and the leukemia get worst? Could it progress to a different form of Leukemia?? Random questions i lknow, but confused.

Hi,

There have been some postings here on Forum in the past re the use of the bone marrow biopsy as opposed to relying on the much less invasive use of peripheral blood i.e.the pcr of bcr/abl.The traditional approach I believe was that on diagnosis one had a biopsy to confirm diagnosis and to establish the presence of Ph+  the Philadelphia chromosome and also the likely percentage leukaemic cells present in the bone marrow at dx;it seems that the maximum number of biopsies taken was usually two and also just taken in the first year -then the haematologist would rely on peripheral blood.I remember for some reason having 3 in total.

I know that some specialists are happy to rely right from the start on the peripheral blood approach as the biopsy is invasive, and in a minority of cases there is bleeding or an infection that results.

No doubt your specialist has reasons to want to take another biopsy probably just to see what is happening in more detail.Have you had mutations analysis which basically is an add on to your pcr/bcr abl ,as if  a new development  is confirmed it can be matched to the need for using a specific tki such as Sprycel-and is evidence to your insurance company .I guess your situation is about money from your insurer as imatinib genericis is the cheapest and Sprycel is more expensive than Tasigna.

If you refer to the posting here recently(see Forum) on the Hammersmith Hospital here in UK offering an online advice service for free so why dont you ask them for an opinion.?You would need to quote your pcrs and bloods in detail if possible though.

Regards

John

I was diagnosed in October 2020. Had one bone marrow biopsy, now they want to do another one. I had a mutation test when I switched from Imatinib. Came back normal I am assuming, because I didn’t hear otherwise and that was in October of 2021.

 

my insurance says Tasigna was second in line then comes a Sprycil. 

it’s all odd to me. I raised concern a month ago about the lowering Blood cell counts, because this happens on Imatinb too.

 

They probably want to run a karyotyping test to see if there are any other additional chromosomal abnormalities rather than looking for percentage blast cells.  That of course is just a guess, but it would be something to look at that is different than mutation testing, or percentage blast testing.  I hope you find the right TKI and/or dose for you and your counts get healthy.  Take care.