In a message dated 6/6/2013 10:19:31 A.M. Eastern Daylight Time,  
[email protected] writes:

Carol.....I had the same problem....what finally fixed the Pleural  
Effusion for me was to reduce the dose....They (MD Anderson) took me down  
gradually from 100 mg/day....and I have been on 20 mgs/day for over a year now  
and 
it seems to be working....no PE and good blood results/PCR's.  In  addition 
the other side effects are much better at the lower dose!   Everyone reacts 
differently to these TKI's...so you need to do this under good  supervision. 
 As you can see from my complete history below I took a long  journey to 
find the right one/dose.  Hope this helps!
 
Tom in KY
 
Tom Dunham, BD: 8/1941 Updated::4-7-13
DX CML  12-23-2008
MDA Protocol: Tasigna-400mg; 2xday-1/09
On Flecainide for  AF...still had frequent episodes
Q PCR bone@ 0.17 on 7/09
Acute  Pancreatitis-7/5/09
Stopped Tasigna-7/13/09
Q PCRU blood-7-29-09  !
Started Gleevec-400mg/day-7/31/09
Developed rash ~ 8/19/09
Rash  treated with Steroids..improvement
Rash worsens~9/22/09
Stopped  Gleevec-9/28/09
Restarted Gleevec @300mg/day-10/8/09
Stopped  Gleevec-10/13/09-toxic rash\
AF returned infrequently
Q PCR  bone-0.05
Started Sprycel @ 100mg/day-10/20/09
Some AF...increased  FLecainde..1, 2x/day
Q PCR bone..0.07
Stopped Alcohol…no AF, ½  Flecainide 2x/day
Q PCR Blood…Non Detectible-12-13-10
Q PCR  Bone..0.01--2-25-11
Q PCR Blood…Undetectible-5-19-11
Reduced Flecainide  to 1/2 per day
Pleural and pericardial Effusion: stopped  Sprycel-12-6-'11
Prednisone 50mg /day to combat PE; 12/14/'11 gradual  reduction
Pleural Effusion clear 12-21-11
Started Sprycel  70mg/day..12-23-11
QPR bone <0.01...2-16-12
Started Sprycel  50mg/day..3-10-12
Chest pains...slightly more PL Eff 4-19-12
Steroid  Dose pack to alleaviate..still on 50mgs
Change to 20 mgs/day  Sprycel..4-26-12
Chest clear, effusion gone-5-14-12
Q-PCR  Blood-Undetectible-6-13-12
Neuropathy moving up legs, weakness noted  ~7-12
Q-PCR Blood MDA-<0.01…8-21-12
Q-PCR Bone  MDA-<0.01...3-5-13
 


On Jun 6, 2013, at 7:46 AM, [email protected]_ (mailto:[email protected])   
wrote:

 
I haven't posted in a while, but always read everyone else's...now i have  
a question for everyone on Sprycel. I was switched to Sprycel 2 years ago 
due  to kidney issues with the Gleevec. I was diagnosed in July of 2001.Have 
been  undetectable for years...now I am getting pluerral effusions.   I  just 
had the second one drained yesterday....The onc has taken me off Sprycel  
for 2 weeks.....In everyone else's experience does that seem long  enough.   
I took an 8 day break a month ago but the effusion was  back in 5 
days....probably was going to happen anyway....I think he is being  very 
cautious, but 
just wondering what everyone else has done...went into the  archives and 
learned a lot....but need a little more advice to argue my point  of a longer 
break....thanks....Carol Kalat









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