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pcr

Hi everyone, Rob's 1st PCR after 3 months on Dasatinib is just back at 1.5% down from 2% for his last PCR on Glivec. Given that it took him over 2 years to get to 2% on Glivec He is concerned that he will have an equally slow response to Dasatinib and that the longer it takes him to get to a good pcr the poorer his long term prognosis. Dr Graham Smith at Leeds says it is early days on the new drug and to wait and see, with the possibility of transplant if it's deemed necessary. He is 38 and has 2 matched sibling donors, and is begining to think he should go down this route as he has a good chance of a good outcome. He has been more unwell on Dasatinib than on Glivec
Just wondered if anyone had any helpful thoughts,thanks,
Sal

Hi Sal
May be it is a bit early to expect the PCR to vanish after just three months. I would say give it another 3 and then think about options. Rob is in a good position for a transplant if need be, he is young and has two matched sibling donors - he could investigate the mini transplant/reduce intensity allograft - this carries much less risks than the full BMT and with two sibling donors Rob could wave good bye to CML for good !
Are you both coming to Edinburgh in November ? It would give you the opportunity to discuss Rob's situation at that time with leading experts in the field of which Dr Smith is one.
If Rob has trouble tolerating Dasatinib, may be he could enroll on the ENACT trial for Nilotinib ? Nilotinib/Tasigna has a much lower side effects profile than Dasatinib/Sprycel.
Best wishes
Elizabeth