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Alcohol and question about platelets

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Hi ,

We are four weeks into our treatment and the blood results are all within the ‘normal ranges’. Platelets dropped from 500k to 230k in the first three weeks aswell as wbc down to 8 from 50k.  Basophil, neutrophils etc are also within the norm. 
 

Is it ok to consume alcohol in small amount if her liver levels are all within the ranges? Does it have any impact on Dasatinib or CML? She takes sprycel in the morning, so it shouldnt interfere with alcohol in the evenings i suppose.  
 

second question - We are slightly concerned about the big drop of platelets - everything is more or less stable, haemoglobin red cells etc are all good, its just the platelets that are dropping. Is it normal for them to drop so much and will just stabilise?, as our concern is that they will continue to drop. We believe that the protocol is to take action when they drop below 50k, but we think that if the trend continues to go downards maybe its worth taking action beforehand for example when they are below 100-80?

 

looking forward to your replies

It's quite normal for platelets to drop especially when starting out high during early treatment. Dasatinib is a potent myelosuppression agent, so it is important to monitor blood levels (neutrophils & platelets, in particular). No action is needed unless platelets fall below 50k. You want her normal blood system to be stimulated to replace leukemic cells and normalize. Avoid stopping treatment prematurely. As long as blood counts are safe albeit 'low', this helps spur new normal cell growth while the TKI keeps killing pressure on leukemic cells. Over time, her normal blood system will take hold and her leukemic one will largely disappear and only PCR will let you know it is still present. In my early dasatinib stage, I was monitored for CBC counts once a week in order to catch a drop below safe levels.

Regarding alcohol - as long as liver enzymes are normal, having one or two drinks is perfectly safe. Alcohol metabolism does not affect dasatinib (or the other TKI's) in any known way. I drink wine every day and have been for decades before, during and after TKI treatment. And a scotch now and then when friends visit.

Thanks for your reply Scuba, as always very informative.  We had our consultation Today and her results are great :) the wbc had actually stabilised and are hovering between 8.7-9.2, platelets only dropped from 230-200 since last Wednesday and the Dr. Had decided to change weekly blood tests to every two weeks.  
 

Also in regards to curcumin, we had lowered the dose to 2g daily as she experienced small nosebleeds, which are now gone. We are aiming to resume to take 6-8g as we did before the nosebleeds, do you think its a good time to increase curcumin now or perhaps wait a bit longer for the platelets to stabilise further? 

As long as she tolerates Curcumin (i.e. nosebleeds), I am a strong supporter of Curcumin's health benefits (and Selenium) in messing with CML.

There is no doubt, in my mind, she will beat CML. She is well on her way. But by adding the nutritional support to augment what dasatinib is doing, she can work towards eliminating CML as a health concern. I have recently added NMN to my program. Research Dr. David Sinclair. Interesting work he is doing.

We are also  into nutrition and supplementation and believe that the appropriate nutrition  can help with the side effects of the drug and perhaps enhance its effectiveness. We both take supplements daily, as its difficult to get all the values from a diet itself.

We also observed fatigue and headaches in the first 2 weeks of starting treatment and found out that the fatigue tend to appear on the days my partner is less active or has days off work, so instead of resting- we added a little exercise to the routine which eliminated the fatigue. We note each potential side effect and try our best to add a small description of our day and food we eat on the day a side effect appear. We were able to find correlation between ‘Lazy days’ and fatigue. 

Thanks for the info on NMN, will start doing some research on it.

For now we are supplementing: 

5,000 iu vit d3 with k2 as mk7 ( we also try to catch some sun between 13-14:00) 

25mg zinc

1000mg vit c split into 2 doses of 500mg

Selenium 200mg on the days we dont eat nuts

Magnesium citrate &malate 250-500mg 

b12 complex 

Seems a-lot, especially when trying to split doses throughout the day, but its working for us for the time being.  Perhaps it has no or little impact on CML itself, but theres no reason for not taking these supplements, but hopefully by adding these supplements alongside a good diet we can boost our immune system by a little, decrease inflammation and overall be more healthier.