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Re: for Lottie

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AH HA! LOTTIE, THAT MEANS YOU AND I ARE GOING TO LIVE, AND LIVE AND LIVE

ETC. ETC. ETC.

On Thu, May 21, 2009 at 11:47 AM, Cogan <ncogan@...> wrote:

>

>

>

>

> The word remission has a nice ring to it, and the fact that it evades me no

> longer bothers me. If I can live 13 years without it, then maybe I didn't

> need it in the first place.

> _______________________

>

> Hi Lottie, my friend,

> Time for a little attitude correction. You ARE in a remission of sorts.

> Even if you are 100% ph+, if your white cell count is not increasing, you

> are in a hematological remission (or response). Your disease is being

> controlled by whatever cml drug you are taking....otherwise your white count

> would be climbing, which is it now (but did in the beginning when your

> disease was not controlled).

>

> Also, when people first went on Gleevec, I asked Dr. Druker how they would

> know that the drug was preventing the progression of the disease (through

> the various stages) and he said " we won't really know for 5 years until we

> see what the death rate is of people on Gleevec. " At 5 years they expect a

> certain (fairly large) % of people with cml to have died but because that is

> not happening, they know that the progression of the disease is being halted

> by the drug (ie that the drug is working). You are there, my friend!

>

> The problem with having more cml cells (a higher % that are ph+) is simply

> that you have more cml cells that could mutate and be harder to

> treat.....but the longer time that goes without this happening (per Dr.

> Druker) the less likely that is to happen. So, your cml cells are probably

> more stable or reliable than someone who is newly diagnosed (when the nature

> of their cml is not known).

>

> And, here is where a great diet with lots of anti-oxidants is good for

> you....mop up those free radicals so that they can't do more DNA damage to

> your cml cells.

>

> So, my opinion is that you can say that your disease is in remission (it is

> not progressing, your white count is not climbing) because of your drug.

> Even being 100% ph+ as long as stable is a good thing.

>

> your cml buddy....Maui Nanc

>

>

>

--

a Doyle/dob 1929

DX 1995/Hydrea

2/00 - Gleevec Trial, OHSU, Dr. Druker

6/02 - Gleevec/Arsenic Trial, OHSU,Dr. Druker

6/03 - Gleeved/Zarnestra Trial, OHSU, " " " "

7/06 - Sprycel Trial, MDACC, Dr. Talpaz

4/08 - XL228 Trial, U. of Michigan, Dr. Talpaz

4/09 - Ariad Trial, U.of Michigan, Dr. Talpaz

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Guest guest

Hi ,

Well said.

My pet peeve is all those doctors out there who think that it is important

for a patient to achieve PCRU if you have CML. They will increase the dose

to get the extra log reduction. You would think that if they were treating

patients with CML that they would at least read up on what level of

remission is appropriate for patients.

You have explained that as long as the CML is kept in check over time (say

2 years) then it really doesn't matter what level of remission you are at.

Any numbers that I have seen state that there is no difference in survival

rates between a 3 log reduction and PCRU.

Zavie

Zavie (age 70)

67 Shoreham Avenue

Ottawa, Canada, K2G 3X3

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

2.8 log reduction Sep/05

3.0 log reduction Jan/06

2.9 log reduction Feb/07

3.6 log reduction Apr/08

3.6 log reduction Sep/08

3.7 log reduction Jan/09

e-mail: zmiller@...

Tel: 613-726-1117

Fax: 309-296-0807

Cell: 613-282-0204

ID: zaviem

YM: zaviemiller

Skype: Zavie

_____

From: [mailto: ] On Behalf Of

Cogan

Sent: May 21, 2009 11:47 AM

Subject: [ ] for Lottie

The word remission has a nice ring to it, and the fact that it evades me no

longer bothers me. If I can live 13 years without it, then maybe I didn't

need it in the first place.

_______________________

Hi Lottie, my friend,

Time for a little attitude correction. You ARE in a remission of sorts. Even

if you are 100% ph+, if your white cell count is not increasing, you are in

a hematological remission (or response). Your disease is being controlled by

whatever cml drug you are taking....otherwise your white count would be

climbing, which is it now (but did in the beginning when your disease was

not controlled).

Also, when people first went on Gleevec, I asked Dr. Druker how they would

know that the drug was preventing the progression of the disease (through

the various stages) and he said " we won't really know for 5 years until we

see what the death rate is of people on Gleevec. " At 5 years they expect a

certain (fairly large) % of people with cml to have died but because that is

not happening, they know that the progression of the disease is being halted

by the drug (ie that the drug is working). You are there, my friend!

The problem with having more cml cells (a higher % that are ph+) is simply

that you have more cml cells that could mutate and be harder to

treat.....but the longer time that goes without this happening (per Dr.

Druker) the less likely that is to happen. So, your cml cells are probably

more stable or reliable than someone who is newly diagnosed (when the nature

of their cml is not known).

And, here is where a great diet with lots of anti-oxidants is good for

you....mop up those free radicals so that they can't do more DNA damage to

your cml cells.

So, my opinion is that you can say that your disease is in remission (it is

not progressing, your white count is not climbing) because of your drug.

Even being 100% ph+ as long as stable is a good thing.

your cml buddy....Maui Nanc

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  • 4 months later...

Hi , when I had the procedure done, the tall handsome doctor walked in, put

in the needle, walked out and two nurses finished the job, I never saw him

again.  You are most likely quite right, it was drawn in a very short amount of

time.  B obby

a (Bobby) Doyle Brecksville, Ohio, USA DX 05/1995

Interferon/9 weeks/hydroxyurea/5 years

02/2000 - Gleevec Trial/OHSU 06/2002 - Gleevec/Trisenox Trial/OHSU 06/2003 -

Gleevec/Zarnestra Trial/OHSU 04/2004 - Sprycel Trial/MDACC, CCR in 10 months

#840  -   Zavie's Zero Club 09/2006 -  out of CCR 04/29/08 - XL228 trial/U of

Michigan

01/09/ - PCR 5.69

02/13/09 - XL228 trial ended due to side effects

o4/13/09 - Ariad Trial U of Michigan

09/09/09 - PCR 0.017

04/13/09 - Ariad trial at U. of Michigan

09/09/09 - PCR 0.017

04/13/09 - Ariad trial, U. of Michigan

09/08/09 - PCR 0.017

From: hey00nanc <ncogan@...>

Subject: [ ] for Lottie

Date: Monday, October 5, 2009, 2:30 PM

 

My pulmonologist is already talking about draining my lungs,

but I want him to confer with MDACC first, as he is not aware that the SKI could

be the culprit. I remember Bobby talking about how painful the procedsuyre was.

____________ _________ _

Hi Lottie,

I had this procedure years ago in my onc's office.....sat on the table, leaned

forward against a support and he numbed between the ribs, made a cut and stuck

the needle in and took off about 800mg of fluid. Like a bmb, I think it depends

on the experience of the person doing the procedure... ..mine was not bad at

all.

Even Bobby wrote that the procedure itself did not hurt. Bobby, I think that

maybe they drew off the fluid too quickly for you, ?? creating a vacuum and that

caused all the pain (just like doing a bmb aspiration too quickly hurts, but it

is briefer).

Another point is that if the drug is causing the pleural effusion, then drawing

the fluid off will not resolve the problem and it usually comes right back.

Also, going off drug may help get rid of it....but if it is a large amount then

they might want to get rid of it faster. I recently had a small PE on Sprycel

and OHSU said that most people don't bother to have it removed.

Glad you are back on the list. You are always so welcoming to our new cml

friends.

C.

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>

> Hi , when I had the procedure done, the tall handsome doctor walked in,

put in the needle, walked out and two nurses finished the job, I never saw him

again.  You are most likely quite right, it was drawn in a very short amount of

time.  B obby

___________________

Hi Bobby,

You were probably annoyed that the good looking doc did not stick around! tee

hee

My doctor did the entire procedure, and he wanted to see my face (to monitor my

reaction) while he did it. There is one risk...it is possible to puncture the

lung. I asked him what happens it that happens....and he said 'you go to the

hospital'. I really had no pain during or after the procedure....but I am sure

it varies for people.

C.

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