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Should I Increase Dasatinib dose from 50mg to 100 mg?


Hi all,

I started 50 mg of Dasatinib last year in April. By October, my BRC-ABL test result was 0.0087, which was down from 0.50 on Imatinib after 5 years on it. However, yesterday, I tested and I am now up again to 0.03. I know it's under 0.1 but still, it rose up. Please note that initially, when I started Dasatinib, my doctors wanted me to begin with a 100 mg dose, which I refused to do after reading here how the low dose can help too. But at this moment, I am not sure what I can do. I was in the stage of thinking about starting a family and was happy with Dasatinib getting me there, but now what do I do? Accept to increase to 100 mg and hope that it gets me undetected or stay on 50 mg and see what happens the next time I test.

Many thanks

Yvette, there isn't any reason for you to do anything other than test again in another three months. Not everyone achieves undetected and it isn't at all unusual for BCR-ABL readings to have variations at low CML levels.


Hi, that’s still really low.I wouldn’t go on 100 mg it will make you feel very ill I think , it’s too toxic .Pleural effusions are very likely too ,ruin your lungs .Please stay the course and see how it goes ,there’s no hurry .More isnt better .Good luck .Denise.

You need a trend before adjusting dose or switching drugs. Any single PCR result < 0.1% has a higher "noise" level. The difference between 0.01 and 0.03 is within the noise of the test. You can easily wait until your next test (3 months) and see if you levels fall back or establish an upward trend.

So any fluctuations below MMR 4 is all noise?

Yes. The fluctuations are within the accuracy and precision of the PCR test. 1/2 log up or down can be expected from the same blood sample.
At MMR4, residual presence of bcr-abl is very very very small.

I am in similar situation. I finally reached a 4 log reduction after switching from 100mg to 80mg sprycel ( .007 IS) . 8 weeks later I took a test yesterday and my results are no .015 IS. I am assuming you will say not to worry to much? THis the biggest jump I have experienced so a lil bummed today. I was so excited to get to 4 log and than bam.

This change from .007 to 0.015 is not statistically significant - it is well within the error band of the measurement technique at this low level. I would suggest that if it rises again at both of the next 2 tests you should talk to your doctor - but I would bet that it won't.