I hope you will be able to get the levels down further soon. The BMS or AMN drugs would probably be good options if that is needed.
 
Rob
 
----- Original Message -----
From: Dane
Sent: Monday, April 25, 2005 4:24 PM
Subject: [CMLHope] 76 Days Post BMT----First Setback

Day 76 brings my first setback since the BMT process began.
 
I received the results of my second biopsy today.  It showed that I am now 100% donor cells (good) but my BCR-ABL level is up to 13.5 (not good).
 
In comparison,  my first biopsy came back 99% donor cells and a BCR-ABL level of 1.0.
 
Dr. DeLima explained to me that the anti-GVHD drug tacrolimus also reduces the donor cells' ability to fight the leukemia, so now my tacrolimus dose will be decreased.
 
The plan is to induce a small amount of GVHD in order to achieve Graft Vs Leukemia. Graft Vs Leukemia can start to bring the BCR-ABL level back down.
 
Dr. DeLima has also mentioned the possibility of bringing Gleevec back into the mix, but I have my doubts about this because I have already shown a resistance to the drug.  I talked with him as well as with my research onc about replacing the use of Gleevec with one of the newer BMS or AMN107 drugs to knock out the BCR-ABL and give my new immune system a helping hand.
 
He thought enough of the idea to email my research onc to get his opinion.  I sent my research onc a similar email and expect to hear back from him soon.
 
In the meantime, any chance of going home early is now gone, as my test results were not optimum.  I will be here for at least another month, possibly longer.  The good news is that as of this writing, I should still be allowed to go home on weekends.
 
As of this writing, I am still only in clinic two days a week, and I am still off home infusions unless my magnesium levels drop lower than they are.
 
So I wait....three more weeks until another biopsy, one more week to get those results.
 
Tick....tock.....tick....tock, etc.
 
Not the best day I've had since this thing began.
 
Dane


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