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, _Cakrek@aol.com_ (mailto:cak...@aol.com)   
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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