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TEETH

Hi, Rachel here again. So far Gary is doing well on Dasatanib, been on it about 8 weeks now. However, he only just mentioned to me that his teeth seem to be eroding. I had a look and they are indeed looking pretty bad, especially the top layer of teeth. On the front ones particularly, it looks like the enamel is eroding away from the gumline downwards and I wondered if this had anything to do with CML drugs or the way they affect bone marrow? All I know is that bones and teeth contain calcium and I thought maybe the CML drugs could be attacking the calcium producing part? Whether calcium is actually produced in the bone, I do not know! I would appreciate other peoples comments or experience.

On another tack, we found out that the results of Garys BMTest on 15/10/07 showed that his Ph+ count was back up to 70%. He had a test done when dx in Aug 2004 and it was 100% back then. He reached CCR 6 months later on 400mg Glivec but 18 months after this his dose was increased to 600mg as PCR counts were starting to rise. They never really dropped and hence the Dasatanib. Could he have gone into Blast Phase with a PH+ count of 70%? Incidentally, his counts have dropped even in the short time on Dasatanib and I believe he is receiving the best help and treatment available by going to Manchester. Again, any comments would help. Thanks to you all and Merry Christmas xxx

Hi Rachel,
The ph+ % does not necessarily correlate to blast phase.....you can be 100% ph+ and still be in chronic phase. You determine blast phase by the % of blast cells (immature cells) in either the peripheral blood or more accurately in the bone marrow aspirate. What counts have dropped while he has been on Dasatinib?

I think the acidity of these drugs can affect the teeth, especially is someone if having a problem with acid reflux. If this is a problem, you want to counteract the drug acidity with a highly alkaline diet (lots of leafy greens, fruit and other veggies, less meat, etc...you can find a list of alkaline foods on the internet).

Hope this info might help a bit,
Nancy C. (Eugene, Oregon)

Thank you Nancy for your information. I have booked a dentist appointment for Gary in the New Year. I think a calcium supplement and an increase in his milk intake may also help. He drinks a lot of tea and I am told that its acidic qualities can also be detrimental. Is acid reflux 'indigestion'?
RACHEL

Hi Rachel
Teeth - I can agree with what is happening with Gary, I did take up this with my dentist friend, and she told me that it was a side effect of having cml and the treatment program. I had a similar happening, but it stopped after a bit of gum regression, so dentist should be able to sort this out. Being 100% Ph+ve does not mean that Gary is going into blast phase, I was on Glivec for 5 years, but regression leveled out, so onto Dasatinib at lowest dose, and slowly, very slowly we are getting towards zero, donn't worry too much as all sounds a bit familiar.
Keep having fun
Keep smiling
Keith

Hi Rachel,
YES, acid reflux can be called indigestion or heart burn...it is actually very common in even healthy people. On 800mg of Gleevec, I had acid reflux for quite a while....and my dentist said it was causing some very small cavaties at the base (near the gum) of my teeth, that were not usual at all. I live in the US and I used a product called Acid Defense, made by Garden of Life.....but it was basically to reduce the acid in my system. By changing my diet, I did clear up that problem.
Nancy C.

Thank you Keith and Nancy for your information. We will discuss all options with the dentist in the new year. Better start saving the pennies, think its going to be costly! Does anyone know if you can get funding for dental treatment if poor teeth are a side effect of CML and its treatment?

RACHEL