A setback.....and a look ahead

[Guest guest]

I have been on 400 mg of Gleevec since December 1. My FISH test in

March was 25% and my FISH test in June just came back at 43.5%. My

onc. has increased my dosage to 600 mg. Do my fellow posters (esp.

Tracey) feel this is a minor setback or something more serious? Does

it appear I am developing a resistance to Gleevec? Or, is it still

too early to make such a determination? Thanks in advance for any

information.

[Guest guest]

My husband had the same problem. He was diagnosed in July of 2006 and

finally began Gleevec in August 2006. By December we were at .07

Fish. Then in February the numbers began to slowly climb. We waited

a few months to make sure there was a rising trend and that turned out

to be the case. The Dr. upped our level of Gleevec from 400 to 800

and we are now waiting for our next PCR test result. ( The Dr.

switched from Fish to PCR as it is more sensitive). We did realize

that during that time my husband had started combining his medicines.

He takes Trileptal for a seizure disorder and had been taking the

pills at different times of the day. In December he decided to just

take them all at once and all of a sudden we started having

disappointing test results. Since we have found out that both

Trileptal and Gleevec bind to the same protein he takes them 3 hours

apart. We are now hoping that the increased dosage along with the

separation of pills will bring us a PCRU result!!!! Hang in there.

There can be many reasons for an increase in your results. This is

our story and I hope it has a good ending. All I can say is you must

be your own advocate any REALLY pay attention to what you put into

your body. Until we researched the meds, the Drs. didn't mention that

combining drugs could be a problem.

Best of luck! Hope this helps.

Debbie

>

> I have been on 400 mg of Gleevec since December 1. My FISH test in

> March was 25% and my FISH test in June just came back at 43.5%. My

> onc. has increased my dosage to 600 mg. Do my fellow posters (esp.

> Tracey) feel this is a minor setback or something more serious? Does

> it appear I am developing a resistance to Gleevec? Or, is it still

> too early to make such a determination? Thanks in advance for any

> information.

>

[Guest guest]

Hi Tinman,

Most FISH tests look at about 200 cells so if we assume that your FISH

test was a " standard " test, the March result would have found roughly

50 bad cells and the June result would have found 87. That's a not a

huge discrepancy when you take into account the margin of error and

other variables. Were both tests done using peripherial blood or was

one peripheral and the other marrow? That can have an effect on the

results as well. Regardless, it's not at all unreasonable to increase

your dose considering the increase in numbers.

I definitely think that it's too early to be worried. See how your

next test goes and then you'll have a better idea of how your body is

responding to Gleevec. If your numbers go down, fantastic, and if they

go up, you can consider a variety of things such as increasing to 800mg

or trying Sprycel.

Do you have another BMB planned anytime soon? Most doctors will do

BMB's every 3-6 months until a patient reaches CCR so they can have a

better understanding of what's going on in the marrow.

In the mean time, you should look at all the other things you're taking

(if any) as you've seen from recent postings that there are many things

that can have an effect on how you metabolize the drug. Are you taking

other drugs? Are you taking any vitamins? Even taking calcium at the

same time as Gleevec can inhibit the absorption of Gleevec so you

really want to avoid taking anything at the same time.

Take care,

Tracey

>

> I have been on 400 mg of Gleevec since December 1. My FISH test in

> March was 25% and my FISH test in June just came back at 43.5%. My

> onc. has increased my dosage to 600 mg. Do my fellow posters (esp.

> Tracey) feel this is a minor setback or something more serious? Does

> it appear I am developing a resistance to Gleevec? Or, is it still

> too early to make such a determination? Thanks in advance for any

> information.

>

[Guest guest]

Tinman,

I would suggest you ask your doctor to test you for mutations. Knowing

what you are fighting gives you the tools to know what the best therapy

approach is for you to succeed in your fight against CML. It's never too

soon to have that knowledge.

Best of luck,

________________________________

From: [mailto: ] On Behalf Of

Tracey

Sent: Wednesday, June 27, 2007 10:14 AM

Subject: [ ] Re: A setback.....and a look ahead

Hi Tinman,

Most FISH tests look at about 200 cells so if we assume that your FISH

test was a " standard " test, the March result would have found roughly

50 bad cells and the June result would have found 87. That's a not a

huge discrepancy when you take into account the margin of error and

other variables. Were both tests done using peripherial blood or was

one peripheral and the other marrow? That can have an effect on the

results as well. Regardless, it's not at all unreasonable to increase

your dose considering the increase in numbers.

I definitely think that it's too early to be worried. See how your

next test goes and then you'll have a better idea of how your body is

responding to Gleevec. If your numbers go down, fantastic, and if they

go up, you can consider a variety of things such as increasing to 800mg

or trying Sprycel.

Do you have another BMB planned anytime soon? Most doctors will do

BMB's every 3-6 months until a patient reaches CCR so they can have a

better understanding of what's going on in the marrow.

In the mean time, you should look at all the other things you're taking

(if any) as you've seen from recent postings that there are many things

that can have an effect on how you metabolize the drug. Are you taking

other drugs? Are you taking any vitamins? Even taking calcium at the

same time as Gleevec can inhibit the absorption of Gleevec so you

really want to avoid taking anything at the same time.

Take care,

Tracey

>

> I have been on 400 mg of Gleevec since December 1. My FISH test in

> March was 25% and my FISH test in June just came back at 43.5%. My

> onc. has increased my dosage to 600 mg. Do my fellow posters (esp.

> Tracey) feel this is a minor setback or something more serious? Does

> it appear I am developing a resistance to Gleevec? Or, is it still

> too early to make such a determination? Thanks in advance for any

> information.

>

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[Guest guest]

Hello,

I was just wondering why they are tracking with a FISH, when a

real time PCR is so much more accurate?

Mel

DX 6/2006

Gleevac 400mg until 3/07

AMN107 May 07 to Present

800mg

> >

> > I have been on 400 mg of Gleevec since December 1. My FISH test

in

> > March was 25% and my FISH test in June just came back at 43.5%.

My

> > onc. has increased my dosage to 600 mg. Do my fellow posters

(esp.

> > Tracey) feel this is a minor setback or something more serious?

Does

> > it appear I am developing a resistance to Gleevec? Or, is it

still

> > too early to make such a determination? Thanks in advance for any

> > information.

> >

>

[Guest guest]

Hi Mel,

Most doctors feel that a FISH and/or cytogenetic test can give a more

accurate picture of what's going on when a person is early on in

their diagnosis (when the leukemic load is high).

PCR's are more useful than FISH and cytogenetics when measuring

minimal residual disease (after a person has reached CCR) which is

why most doctors will continue doing BMB's with cytogenetic and FISH

testing regularly until CCR is achieved.

Tracey

> >

> > Hi Tinman,

> >

> > Most FISH tests look at about 200 cells so if we assume that your

> FISH

> > test was a " standard " test, the March result would have found

> roughly

> > 50 bad cells and the June result would have found 87. That's a

not

> a

> > huge discrepancy when you take into account the margin of error

and

> > other variables. Were both tests done using peripherial blood or

> was

> > one peripheral and the other marrow? That can have an effect on

> the

> > results as well. Regardless, it's not at all unreasonable to

> increase

> > your dose considering the increase in numbers.

> >

> > I definitely think that it's too early to be worried. See how

your

> > next test goes and then you'll have a better idea of how your

body

> is

> > responding to Gleevec. If your numbers go down, fantastic, and

if

> they

> > go up, you can consider a variety of things such as increasing to

> 800mg

> > or trying Sprycel.

> >

> > Do you have another BMB planned anytime soon? Most doctors will

do

> > BMB's every 3-6 months until a patient reaches CCR so they can

have

> a

> > better understanding of what's going on in the marrow.

> >

> > In the mean time, you should look at all the other things you're

> taking

> > (if any) as you've seen from recent postings that there are many

> things

> > that can have an effect on how you metabolize the drug. Are you

> taking

> > other drugs? Are you taking any vitamins? Even taking calcium

at

> the

> > same time as Gleevec can inhibit the absorption of Gleevec so you

> > really want to avoid taking anything at the same time.

> >

> > Take care,

> > Tracey

> >

> >

> > --- In , " tinman1939new " <tinman1939new@>

wrote:

> > >

> > > I have been on 400 mg of Gleevec since December 1. My FISH

test

> in

> > > March was 25% and my FISH test in June just came back at 43.5%.

> My

> > > onc. has increased my dosage to 600 mg. Do my fellow posters

> (esp.

> > > Tracey) feel this is a minor setback or something more

serious?

> Does

> > > it appear I am developing a resistance to Gleevec? Or, is it

> still

> > > too early to make such a determination? Thanks in advance for

any

> > > information.

> > >

> >

>