RE: Where can I find articles or info?

[Guest guest]

cam on first dxt the usual is 400 unless bad side affects to get count down and

get the big 0 Are you in us!

[ ] Where can I find articles or info?

Hello everyone,

Right now my doctor has me on 200mg of Gleevec due to low blood counts. I want

to

convince him that I need a higher dose. Where can I find articles or info where

some top cml

doctors have said that low doses are not good? I have been looking online but I

can't seem to

find anything.

Cam

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[Guest guest]

Hi Cam,

It seems to me that you are constantly trying to educate your doctor

who doesn't seem to be very knowledgeable about CML or Gleevec. Have

you considered finding another doctor, one who has a little more

experience with CML and who is willing to work for you, not expect you

to find him all the information?

Here are some articles that talk about subtherapeutic dosing and how it

can induce resistance. I've copied and pasted the relevant sentences:

http://www.nature.com/leu/journal/v16/n11/full/2402741a.html

" In order to circumvent resistance, the use of subtherapeutic dosages

of imatinib (<300 mg/day) should be avoided. "

http://theoncologist.alphamedpress.org/cgi/content/full/9/3/271

" it is inadvisable to give subtherapeutic dosages of imatinib (i.e.,

less than 300 mg/d). "

http://www.asheducationbook.org/cgi/content/full/2001/1/87

" For patients with prolonged times to recover their peripheral counts

(e.g., greater than 2-4 weeks), consideration should be given to

reducing the dose to 300 mg and to re-escalating to 400 mg after

several months only if myelosuppression does not recur. As noted above,

dose reductions below 300 mg are not generally recommended since these

doses are subtherapeutic " .

I hope this helps,

Tracey

>

> Hello everyone,

>

> Right now my doctor has me on 200mg of Gleevec due to low blood

counts. I want to

> convince him that I need a higher dose. Where can I find articles or

info where some top cml

> doctors have said that low doses are not good? I have been looking

online but I can't seem to

> find anything.

>

> Cam

>

[Guest guest]

Hi Cam,

He can start with the paper " Practical Management of Patients With Chronic

Myeloid Leukemia Receiving Imatinib "

http://www.cmlsupport.com/practicalmanagementjourclinonc0303.pdf

They make it very clear in the discussion " it appears that doses below 300

mg per day are less effective and should rarely, if ever, be used. "

I agree with Tracey. The faster you switch to a doctor who has experience in

treating CML patients with Gleevec, the better your outcome will be. Don't

waste your time trying to educate your doctor. Get to someone else quickly.

Zavie

Zavie (age 68)

67 Shoreham Avenue

Ottawa, Canada, dxd AUG/99

INF OCT/99 to FEB/00, CHF

No meds FEB/00 to JAN/01

Gleevec since MAR/27/01 (400 mg)

CCR SEP/01. #102 in Zero Club

PCRU 5/02 at RVH

2.8 log reduction Sep/05

3.0 log reduction Jan/06

e-mail: zmiller@...

Tel: 613-726-1117

Fax: 309-296-0807

Cell: 613-202-0204

ID: zaviem

[ ] Where can I find articles or info?

Hello everyone,

Right now my doctor has me on 200mg of Gleevec due to low blood counts. I

want to

convince him that I need a higher dose. Where can I find articles or info

where some top cml

doctors have said that low doses are not good? I have been looking online

but I can't seem to

find anything.

Cam