My brother (47 yo) who has been diagnosed as having CML for 10 years and has been on Chemotherapy and Immune therapy since then with first lines medications including hydroxyurea, busulphan and interferon alpha (for eight years). He also used Gleevec (for one year). His CML had been controlled well and stayed in chronic phase until recently that his white cell count has been increasing up to 70 K/ul. He does NOT have any other sing for accelerated phase (The patient last bone marrow was done on May 29, 2006 and reported as: blasts: 5%. His peripheral smear: basophils in blood: 6%, platelet count is > 100 K, but < 1,000 K, no increasing splenomegaly).
The patient has never had bone marrow transplantation. Patient Philadelphia chromosome is positive and BCR/ABL gene study: M-BCR p210 is positive, and m-BCR p190 is negative.
So, the patient started Sprycel (Dasatinib) two weeks ago with his new hope. However, his WBC count is still high 80 K/ul and he is in an anxious status and does not know what next step is.
Now I would like to ask your help and answers based on this particular case about the treatment strategy for the patient.
1). What is the percentage of CML patient who respond to Sprycel (Dasatinib) and who does not respond?
2). If patient responds to Sprycel (Dasatinib), how long will the patient who is on chronic phase or accelerated phase respond to Sprycel (Dasatinib ? How to judge?
2). If Sprycel (Dasatinib) does not work, will the Sprycel (Dasatinib) and Gleevec have synergistic effect?
3). Any other choice?
My email addr. Is jamesyliu2002@yahoo.com
Thanks for all of your help.. James