Dear Kelly,
I reiterate that all decisions about your care are yours to make.  One half 
dose of tasigna gave me an eye bleed right after my first brain bleed.  Realize 
your life is yours and the docs don't care as much about it as you do.  You are 
well able to go with monthly or every three month bcr/abl tests to keep an eye 
on your log reduction.  You are Not going to lose your remission quickly.  It 
seems that you should let your body rest for as long as possible before going 
back on the medicine.  I have been off gleevec for four years now and still not 
taking anything.  I am still in cellular remission and get tested every 3 
months to see where I'm at....With all your problems honey, I sure would enjoy 
life awhile without treating the leukemia.  Try to work on your bucket list 
while not on medicine for CML.  That's just my opinion.  Your story makes me 
even more reluctant to try sprycel as my docs recommend.  I hope that new one 
they are working on will have less side affects.  


Blessings,
Susan from Indiana






-----Original Mer kEssage-----
From: patrickemailguard-goog <[email protected]>
To: cmlhope <[email protected]>
Sent: Mon, Mar 21, 2011 2:13 pm
Subject: Re: [CMLHope] HELP!




Kelly,
There's no two ways about it. All decisions about your care are yours, not your 
doctor's. 


To answer your request; I was on Gleevec/imatinib for about 3 1/2 years. 
Gleevec stopped working for me and I started Tasigna/nilotinib a month ago. I 
am taking the "standard" dose of (2) 150 mg capsules twice daily (600 mg/day 
total). This even though the literature indicates that an NNRTI I take 
(Viramune/nevirapine)  an inducer of CYP450 3A4 may decrease the plasma 
concentrations and pharmacologic effects of Tasigna. So a higher than standard 
dose might be indicated but my hematologist-oncologist indicated basically that 
if standard dose Tasigna doesn't work for me she will refer me to M.D. Anderson.

My one-week results - WBC fell from 65k to 30k. I should have my 3-week results 
in a day or so. But I can tell from my internal "leukemia-ometer" that things 
are going better.
The reason I have labs already is also a reason I would be concerned about 
maxing-out Tasigna: I have had base-line, one and three-week EKGs because the 
major although uncommon adverse reaction to Tasigna is QT prolongation.


>From Tasigna.com, "Tasigna can cause a possible life-threatening heart problem 
>called QT prolongation. QT prolongation causes an irregular heartbeat, which 
>may lead to sudden death."


I don't know if there is any correlation between pulmonary hypertension and 
risk of QT prolongation but it's a question I have to have answered if I were 
you.


Oh yeah, side-effects wise, Tasigna has been a cakewalk compared to Gleevec so 
far for me. Although taking Tasigna twice a day on an empty stomach and my HIV 
meds twice a day with food has meant that's ALL I do. I've come up with a 
wrinkle where I am going to get up in the middle of the night and take Tasigna 
and go back to bed so that I just eat my evening meal at slightly European hour 
and can even have a cookie or two while I'm watching TV.


Hang in there,
Patrick


p.s. The weather in Galveston has been 
it's-worth-a-hurricane-in-your-lap-every-couple-of-decades GORGEOUS! It's 
important to enjoy what we're given along the way.

 
--- On Mon, 3/21/11, kellyelise <[email protected]> wrote:


From: kellyelise <[email protected]>
Subject: [CMLHope] HELP!
To: "CMLHope" <[email protected]>
Date: Monday, March 21, 2011, 12:31 PM


Hi folks:

I don't know who has read my previous posts, but, I am asking for some
help here. I was diagnosed with pulmonary hypertension as a result of
taking Sprycel. My heart is severely damaged to the point where it
cannot pump enough oxygenated blood into my lungs. I know have a
Hickman catheter in my chest and have to carry around a bag with a
pump that continuously supplies Remodulin to my heart in an effort to
control the pulmonary hypertension and hopefully remodel my heart.
This appears to be a lifelong device that I will have to learn to live
with. So be it.

That said, I have been off Sprycel since December. My bloodwork is now
coming back "weakly positive" on the BCR/ABL. The onc wants to put me
on max dose of Tasigna. Of course, since I could not tolerate Gleevec
and obviously could not tolerate the Sprycel - I am highly resistant
to his approach.

In private, my nurse practitioner told me that not one oncologist at
Cleveland Clinic will treat CML at low doses. I told her that I know
of people in my CML support group who are on low doses. She asked me
to get as much information as possible so she can present my case.

If any of you would please email me your situation and why you are on
lower doses of the CML drug you currently take, I can cut and paste
the info into an email to send to my NP (you can leave out all details
that would violate your privacy) - but please list your doctor's name,
phone number and address, so she can contact him/her to further my
cause.

Also, if anyone has any information regarding Dr. Druker - especially
phone number or email address - I would very much appreciate it so I
can forward it to my NP. She doesn't have time to research these
issues and she asked me to get as much information as I can and
forward it to her via email. Any studies he is currently involved in -
links to websites - the whole shmiel, I would be eternally grateful.

Keep Fighting Warriors - I intend to!!! :)
Kelly
[email protected]






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