I am surprised that you do not think the Mayo Clinic doctors state
that long-term Gleevec can affect immunity, it says there in black and
white.  It is clear that some studies showed immune system of patients
can be compromised by Gleevec and some do not.  Whether this translates
from the petridish to humans remains to be seen and we certainly have
to look at more patients than Roy and you.  I am sure CML experts will
be studying this in the future as use of vaccines in MRD will be
affected to some extent by this.  Trey, you do not have to WORRY about
this, you just need to be aware of what CML research is saying.  And if
necessary, take precautions.  Like with the heart and Gleevec issue,
the incidence being low does not mean we sweep it under the carpet, we
remain aware of some findings and if a patient has symptoms of
shortness of breath, severe edema, does not hurt to do an
echocardiogram.  It really is the same kind of thing.  Similarly, a
patient experiencing increased levels of infection after Gleevec
therapy may want to discuss whether Gleevec compromises the immune
system and every bit of research tells something and is of importance.
We do have a few patients who do have more infections after Gleevec
therapy and this may be a possible explanation for this cohort of
patients.  The good news is that the latest from ASH 2006 reports that
infections on Gleevec are decreasing with time.  Do remember that all
CML patients will not have same side-effects and similarly may not have
similar compromise of immune system.  There is enough data from MD
Anderson Cancer Center saying that Gleevec patients have more
propensity to shingles.  Why?  It gives pause for thought.   However,
so far, Gleevec has been remarkably well tolerated by the majority and
has allowed majority of patients to lead normal lives.  A few, it has
not, there are patients I know who are on disability so they cannot
really agree with you that everything is normal.  But, majority are
doing well.

I really was not aware that anyone on this thread said they were scared
of each and every germ.  Mike had two differing medical opinions and I
thought it fit to give some of the abstracts.  He can show them to both
the doctors and see what they say.  We will all learn.



Anjana


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