Re: Lower dose of medication

[Guest guest]

Hi Lilia,

Welcome to the group!

The plasma level testing is fairly new. The initial idea for it was

to ensure that patients had adequate levels of Gleevec in their

system and if not, to increase their dose. In addition, there have

also been patients who were able to lower their dose because their

blood levels were too high.

The minimum dose of 300mg was established many years ago when the

trials showed that patients on lower doses (below 300mg) had sub-

optimal responses (the majority of them anyway). Of course there are

always exceptions and there have been a very small group of people

who were able to achieve optimal responses on lower doses but without

serum level testing to ensure adequate drug levels, no CML expert

would recommend a sub-optimal dose for very long.

Side effects actually have little to do with responses. There are

some who have virtually no side effects (like Zavie) yet have

terrific responses and there are others who have intolerable side

effects and yet not so great responses. It is very common though for

side effects to ease up a little after some time and they also tend

to cycle (come and go) so if you have a bad day or week, you may very

well have a good day or week to follow. Side effects can be a bit

unpredictable that way.

Take care,

Tracey

> >

> > Dear Lilia

> >

> > I had the same thing happen to me on Sprycel.  I couldn't

tolerate

> Gleevec so I was put on the recommended dose of Sprycel.  That

proved

> way to strong for me took about 4 weeks for the bone marrow to

> recover.  I then was started on the lowest dose of sprycel 20mg bid

> and have been at a log 5 reduction for over a year now.  So we are

> all different.   The doctors  sometimes have to play with the doses

a

> little until the correct dose is found.  They will straighten it

> out.  This is a fabulous web site.  You will get alot of

> encouragement.  We are all in the same boat.  I thank God that we

are

> in the age of these wonder drugs even though they are very

> expensive.  The leukemia society is also very helpful if you ever

> have questions.

> > God Bless you

> > Carolyn

> > dx 11-05

> >

> >

> >

> >

> >

[Guest guest]

Hi Tracey,

Thank you so much for your response. I'm scheduled for blood level

test on coming Tuesday. It takes about five days to get the results.

On 30th I have an appointment with Dr. Druker. Unfortunately, I'll

not have the blood level test results by then, but I really hope he

still can clarify some of my concerns. I can manage side effects. I

was able to work with high fever for one week until it became

unmanageable and then I stayed home for two weeks. I'm fine as long

as I can get up and go to work. But if side effects affect my ability

to work then it becomes a huge issue for me. I just hope that I'll be

able to continue working. I'm of course not expecting the same life

style as I had before I was diagnosed, but a little minimum of that I

would be happy to get back. I hope that if it is not cure but at

least a long term drug free remission will be found for all of us in

the near future. It seems that so many groups working on finding cure

for CML patients and in so different ways that it becomes very hard

to even predict which research is most promising. For the past couple

of months I read so many articles and abstracts about CML that I feel

overwhelmed and sometimes lost. Some days I have a hope and some days

I loose a hope. It helps a lot to have a website like this one and to

have people around who can understand you.

Lilia.

> > >

> > > Dear Lilia

> > >

> > > I had the same thing happen to me on Sprycel.  I couldn't

> tolerate

> > Gleevec so I was put on the recommended dose of Sprycel.  That

> proved

> > way to strong for me took about 4 weeks for the bone marrow to

> > recover.  I then was started on the lowest dose of sprycel 20mg

bid

> > and have been at a log 5 reduction for over a year now.  So we

are

> > all different.   The doctors  sometimes have to play with the

doses

> a

> > little until the correct dose is found.  They will straighten it

> > out.  This is a fabulous web site.  You will get alot of

> > encouragement.  We are all in the same boat.  I thank God that we

> are

> > in the age of these wonder drugs even though they are very

> > expensive.  The leukemia society is also very helpful if you ever

> > have questions.

> > > God Bless you

> > > Carolyn

> > > dx 11-05

> > >

> > >

> > >

> > >

> > >