Hello Patrik,
I am sorry to hear of the problems that your fiance is having. It is so difficult to advise you but she is in an expert centre and that is something to be glad about. You are right about having a better chance of a successful SCT if in chronic phase before the transplant. However, with some further chemotherapy (you say she is strong and a fighter) they might be able to reduce the leukaemic load further.
The fact that she still has blasts evident in her marrow after the conditioning chemo/radiation is a worry but she has a sibling donor and this is fortunate. From what you say her doctors are on the case- however, have you asked them if they have considered using one of the other TKI's as well as further chemo?
Depending on the reasons why her disease progressed when she was being treated with imatinib (Gleevec) it might be that her blast cells would respond to either nilotinib or dasatinib- ? A significant number of blast stage patients have responded very well to dasatinib in particular... not maybe over the long term but certainly over the short term. I think dasatinib is quite effective in blast stage. Would this be a possibility?
You could also contact Brian Druker at OHSU who is pretty much at the top of the chain for CML in the US. I will send you a contact email for his clinical nurse Carolyn Blasdel who I am sure would be able to advise you.
Blast stage is pretty hard to treat- but she has a donor and therefore a fighting chance- especially if they can get the blast cells down further with either a TKI alone or in combo with further chemotherapy.
I hope this is of some help
Sandy
