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Finally!! “not detected” result

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I would like to share the good news I received today. My P210 BCR ABL 1 was “not detected”.
I started on Imatinib 400mg on July 29th 2022 qPCR = 50.2% IS
Sept - 21.01%
Nov – 0.608%
Feb 2023- 0.013%
March – 0.024%
Jun – 0.009%
Sep – 0.004%
Dec – 0.003%
March 2024 – 0.000%
Now my goal is to continue reducing the number of Leukemic Cells and to find a method to trigger any dormant leukemic stem cells to divide and kill them with a combination of TKI, supplements like selenium, and my immune system. I like the 3 day fasting, but I am taking Imatinib.
I would like to thank the members of this forum for the amazing amount of knowledge they share with others, it is a great support.

Vlacer

Congratulations! I'm very happy for you!

Sweet! Congrats. I was on Imatinib for over 11 years and never achieved undetectable. This is great news for you. You may be a good candidate someday for TFR. Do be careful if you try to fast because as you know you have to eat with that pill. I tried many times and I screwed up my stomach so tread lightly on that. You can try one meal a day but make sure it’s a full meal.

Congratulations!

Fasting while taking imatinib won't be possible. Imatinib will cause bad nausea on an empty stomach.
What you could do is try a "fasting mimicking diet" https://perfectketo.com/fasting-mimicking-diet/

A fasting mimicking diet puts your body into ketosis and keeps it there for a period of time to enable autophagy to occur at a higher level. Eating a few olives, almonds and avocado on your "fast" days while you take imatinib might work in avoiding nausea. Keeping the calories low may still trick the body into a high autophagy mode. After 5 days you resume normal eating which may trigger blood stem cell renewal.

An alternative is to switch from imatinib to low dose dasatinib (20 mg). There is data suggesting cycling TKI's hits CML harder by attacking the remnant cells differently. Dasatinib is much easier on the stomach and the low dose will likely keep you "undetected" and may even wipe out the rest of the disease which may be lurking below detection.

https://www.nature.com/articles/s41408-023-00823-9.pdf

Thanks Pojo and Scuba for your advises, very interesting article about fasting mimicking diet.
Vlacer

That Fasting Mimicking diet looks like a hard one to do. For me it’s easier to remain in a fast while not eating. The second I eat it’s over. The ship is underway and stopping it, at least for me, is almost impossible. Although like with traditional fasting, the more you practice the better you get at it. And one final thing about eating with imatinib, I tried many ways to fast with that drug and it’s not a good idea in the traditional sense. I even tried to take the pill with just a banana but in the end I developed stomach issues. I had to go on the proton pump inhibitor Omeprozole. You don’t know what the expression heart burn means until your stomach is screwed up. I felt like I was having a perpetual heart attack. Interesting thing here is I learned how drugs like Omeprozole can assist in bringing the BCR/ABL counts lower. But as soon as you stop the drug the effect is lost.

In any event vlacer you’re in an enviable position. Enjoy and I hope it continues forever.

Thanks Pojo,
I agree, it will be better not to take the risk for now because I already have heartburn issues so fasting with Imatinib will make it even worse.
Vlacer