Guest guest Posted April 9, 2008 Report Share Posted April 9, 2008 As we were talking about this issue during the chat, I thought I would pass on some information. Thanks, Rhonda ? http://www.healthfinder.gov/newsletters/relation031008.asp ? ? ? 2008 Gleevec May Disrupt Ovarian Function WEDNESDAY, March 5 (HealthDay News) -- Although it's a much more targeted treatment than standard chemotherapy, the effective and much-touted leukemia drug, Gleevec, isn't without side effects. In women still in their reproductive years, imatinib (Gleevec) might damage the chances of having a baby in the future, according to a case report published as a letter in the March 6 issue of the New England Journal of Medicine. " Although the odds are not known, it is possible that imatinib and drugs with a similar mode of action may impair fertility, " said one of the letter's authors, Dr. Constantinos Christopoulos, deputy director of the 1st department of internal medicine at Amalia Fleming General Hospital in Athens, Greece. " It is not known whether imatinib-induced infertility is reversible. " However, Christopoulos was also quick to point out that this was only a single case report of premature ovarian failure, and it can be difficult to establish the exact cause of the condition. " Imatinib is a very effective drug that has revolutionized the treatment of chronic myeloid leukemia (CML), but knowledge of the effects of its long-term administration is still limited, and close medical surveillance of patients receiving the drug is mandatory, " he said. The patient Christopoulos and his colleagues reported on was a 28-year-old female who had Philadelphia chromosome-positive CML. Each year in the United States, just under 5,000 people are diagnosed with this type of cancer, according to the Leukemia and Lymphoma Society. She was initially given 400 milligrams of Gleevec daily. About one year into her treatment, the dose of Gleevec was increased to 600 milligrams per day, because she still had some cancer cells. She didn't have any severe side effects due to the treatment, though she experienced some skin discoloration and muscle cramping. During the first two years, she also reported having regular menstrual cycles. About two years after she first started taking Gleevec, and about six months after the dose was increased, the woman reported that she was having irregular menstrual cycles and then her periods ceased altogether. Doctors confirmed premature ovarian failure. While it's not possible to definitively prove that Gleevec caused premature menopause, Christopoulos said that based on the timing, the lack of other causes, and the drugs' mode of action, it's the most likely culprit. Gleevec works by targeting tyrosine kinases, which are proteins that are very active in cancer cells. However, these proteins are also expressed by the ovaries. " There are about 60 tyrosine kinases. Can Gleevec be so specific that it only interacts with one of the 60? This drug is pretty good at targeting and hitting the bull's-eye, but it's not perfect, " said Dr. Bart Kamen, chief medical officer of the Leukemia & Lymphoma Society. " Is it worth that risk? You better believe it, " Kamen said. " The side effects of Gleevec compared to what else we do in cancer treatment is mild. It has a wonderful risk-to-benefit ratio. " " The advantages of this drug clearly outweigh the disadvantages, " said Dr. Jay , chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. also pointed out that most women with CML are long past their reproductive years. According to the American Cancer Society, the average age of CML diagnosis is about 67. While most women are already counseled about the risks to their fertility before undergoing any cancer treatment, Christopoulos said that women of reproductive age receiving Gleevec should know that they shouldn't become pregnant while taking the drug, and they may want to freeze some of their eggs before treatment. More information The American Cancer Society has more on Gleevec??. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2008 Report Share Posted April 9, 2008 Hi Rhonda, Thanks for this article. I find it interesting that they refer to this patient as having had " premature menopause " based on the sole fact that her period stopped. Unless there's more that they didn't report, I don't understand how they can conclude this as being menopause since there are several reasons that could be attributed to a ceasation of a menstrual cycle (outside of menopause). As we talked about last night on the chat, I suspect that Gleevec can increase prolactin levels (at least in me it did) and for some women, an increase in prolactin can cause their periods to stop. This doesn't mean that they're in menopause though. I've found that my prolactin fluctuates dramatically (like most of the other side effects). There was a study I found a long time ago showing that some men have experienced gynecomastia (breast growth) but in the article, they attributed it to a lowering of testosterone. There's no mention of prolactin and I'm fairly confident that prolactin was never checked in these men. I'm also fairly confident that very few CML paitents (if any at all) ever get their prolactin checked. I had to specifically ask for mine to be checked so who knows how many people are having abnormal levels out there and don't even know it. There are so many hormones in our bodies, prolactin being just one example and I wonder how many other hormones are being effected. I haven't seen any studies done on this subject at all and unfortunately it seems that none of the doctors has any interest to investigate it. I can't help but wonder what long term damage (or risk) we might have as a result of variously imbalanced hormones and I don't just mean the sex hormones but thyroid hormones and all the rest of them as well. I've always found it interesting (and perhaps not coincidental) that many of the side effects we experience are suspiciously similar to symptoms we would experience if we had an imbalance in a variety of hormones. For example the fatigue,intolerance to cold temperatures, weight gain, muscle and joint pain, thin hair, hypopigmentation, dry skin, puffy face, altered taste or smell, irregular periods, and muscle cramping, can all be related to thyroid function. So I wonder, do the tyrosine kinase inhibitors effect our thyroid hormones as well? More importantly though, I wonder why none of the doctors care about it? Don't get me wrong, I'm very grateful to have Gleevec and I don't doubt for a second that it's kept me alive all these years. I just hope that it doesn't do any harm in the long run....harm that could have been avoided had someone just taken an interest in monitoring hormone levels since hormones are something that could easily be regulated with drugs if the need is identified. Getting off my soap box now Tracey > > As we were talking about this issue during the chat, I thought I would pass on some information. > > > Thanks, > > > Rhonda > > > ? > > > http://www.healthfinder.gov/newsletters/relation031008.asp > > > ? > > > ? > > > ? > > > 2008 > > > Gleevec May Disrupt Ovarian Function > > > > > > > > WEDNESDAY, March 5 (HealthDay News) -- Although it's a much more targeted treatment than standard chemotherapy, the effective and much- touted leukemia drug, Gleevec, isn't without side effects. > > > In women still in their reproductive years, imatinib (Gleevec) might damage the chances of having a baby in the future, according to a case report published as a letter in the March 6 issue of the New England Journal of Medicine. > > > " Although the odds are not known, it is possible that imatinib and drugs with a similar mode of action may impair fertility, " said one of the letter's authors, Dr. Constantinos Christopoulos, deputy director of the 1st department of internal medicine at Amalia Fleming General Hospital in Athens, Greece. " It is not known whether imatinib- induced infertility is reversible. " > > > However, Christopoulos was also quick to point out that this was only a single case report of premature ovarian failure, and it can be difficult to establish the exact cause of the condition. > > > " Imatinib is a very effective drug that has revolutionized the treatment of chronic myeloid leukemia (CML), but knowledge of the effects of its long-term administration is still limited, and close medical surveillance of patients receiving the drug is mandatory, " he said. > > > The patient Christopoulos and his colleagues reported on was a 28- year-old female who had Philadelphia chromosome-positive CML. Each year in the United States, just under 5,000 people are diagnosed with this type of cancer, according to the Leukemia and Lymphoma Society. > > > She was initially given 400 milligrams of Gleevec daily. About one year into her treatment, the dose of Gleevec was increased to 600 milligrams per day, because she still had some cancer cells. She didn't have any severe side effects due to the treatment, though she experienced some skin discoloration and muscle cramping. During the first two years, she also reported having regular menstrual cycles. > > > About two years after she first started taking Gleevec, and about six months after the dose was increased, the woman reported that she was having irregular menstrual cycles and then her periods ceased altogether. > > > Doctors confirmed premature ovarian failure. While it's not possible to definitively prove that Gleevec caused premature menopause, Christopoulos said that based on the timing, the lack of other causes, and the drugs' mode of action, it's the most likely culprit. > > > Gleevec works by targeting tyrosine kinases, which are proteins that are very active in cancer cells. However, these proteins are also expressed by the ovaries. > > > " There are about 60 tyrosine kinases. Can Gleevec be so specific that it only interacts with one of the 60? This drug is pretty good at targeting and hitting the bull's-eye, but it's not perfect, " said Dr. Bart Kamen, chief medical officer of the Leukemia & Lymphoma Society. > > > " Is it worth that risk? You better believe it, " Kamen said. " The side effects of Gleevec compared to what else we do in cancer treatment is mild. It has a wonderful risk-to-benefit ratio. " > > > " The advantages of this drug clearly outweigh the disadvantages, " said Dr. Jay , chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. > > > also pointed out that most women with CML are long past their reproductive years. According to the American Cancer Society, the average age of CML diagnosis is about 67. > > > While most women are already counseled about the risks to their fertility before undergoing any cancer treatment, Christopoulos said that women of reproductive age receiving Gleevec should know that they shouldn't become pregnant while taking the drug, and they may want to freeze some of their eggs before treatment. > > > More information > > > The American Cancer Society has more on Gleevec??. > > > > Quote Link to comment Share on other sites More sharing options...
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