Below is the latest study presented in ASH 2007 by Dr. Cortes on
Sprycel's effect on platelet function.  Those with low platelet count
should show this article to the doctor before thinking of switching.
Sprycel inhibits platelet functions much more than Gleevec does.

Best Wishes,
Anjana


Dasatinib's Bleeding Complications Confirmed, Explained: Presented at
ASH
By John Gever

ATLANTA, GA -- December 12, 2007 -- Reports of bleeding complications
with
dasatinib therapy were confirmed and traced to the drug's induction of
aspirin-like platelet inhibition, according to studies.

The results were presented in two posters here on December 10 at the
49th
American Society of Hematology (ASH) Annual Meeting and Exposition by
senior
author Jorge Cortes, MD, Professor of Leukemia, M.D. Anderson Cancer
Center,
Houston, Texas.

"Patients receiving dasatinib should avoid concomitant therapy with
agents that
may inhibit platelet function," the researchers recommended.

Dasatinib is used to treat chronic-phase chronic myeloid leukemia
(CML) in
patients with unsuccessful results on imatinib. It is also under study
as a
first-line treatment for CML.

Several studies of dasatinib have reported bleeding events in numbers
not seen
with imatinib.

Dr. Cortes's group examined records from two clinical trials of
dasatinib
involving a total of 138 patients. Both were dose-finding studies,
hence
patients received a range of doses, from 15 mg/day to 180 mg/day.

The analysis found that 23% of patients experienced bleeding events.
"This
complication is particularly prevalent among patients with advanced
CML
receiving [at least] 140 mg," the researchers said.

Of the 37 bleeding episodes seen in the studies, 23 were grade 1 or 2,
with the
remaining events all grade 3 (requiring transfusion).

These were managed adequately, Dr. Cortes's group said, with dasatinib
treatment
interruptions lasting a median of 17 days used in about half the
cases.

Platelet counts below 30,000/mcL were seen in 43% of cases; the
platelet counts
were between 30,000 and 100,000/mcL in another 16%.

The findings prompted Dr. Cortes's group to undertake a laboratory
study of
dasatinib's effect on platelet function in comparison with similar CML
drugs
(imatinib, nilotinib, and bosutinib). Standard coagulation tests and
platelet
function analyses were performed on blood samples from a total of 55
patients
taking these drugs.

All but two of these patients showed normal results on prothrombin and
activated
partial thromboplastin time tests.

But platelet function was inhibited with dasatinib "causing an aspirin-
like
effect," the researchers said. Impaired platelet aggregation was found
in
samples from 85% of dasatinib patients, significantly more than in
patients
treated with bosutinib (20%), or nilotinib or imatinib (33% combined)
(P <.006).


[Presentation title: Dasatinib-Induced Platelet Dysfunction; Bleeding
Diathesis
in Patients (pts) With Chronic Myelogenous Leukemia Receiving
Dasatinib Therapy.
Abstracts 2941 and 2958]


On Jan 3, 4:57 am, Trey <[EMAIL PROTECTED]> wrote:
> Between the Gleevec side effects and Lupus, no wonder you are
> fatigued.  Both suppress WBC, RBC, and platelets.  Hopefully your Onc
> has stopped your Gleevec until your platelets recover.  Sometimes a
> Gleevec vacation will get things back on track.  But if it does not
> straighten out soon, then I would ask the Onc about switching to
> Sprycel to see if it works better.  Sprycel does not affect platelets
> the same way Gleevec does.
>
> Here is some info on Lupus and 
> symptoms:http://www.lupusmn.org/Education/Articles/WhataretheSignsandSymptomso...
>
> You should also be tested to see what type of anemia you have.  With
> your RBC count way below normal, you are certainly not getting enough
> oxygen in your body.  You may need to also be taking supplements
> (usually iron and/or folic acid -- but get an anemia test and ask your
> Onc what is needed).
>
> The BMB suggestion seems like a good idea, if one has not been done
> recently.
>
> Here is what the FDA says about Gleevec. See paragraphs 5.3 and 6.2
> especially:http://www.fda.gov/medwatch/safety/2007/Sep_PI/Gleevec_PI.pdf
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