Thank you Jeanie
 
greenie
 
 
 
In a message dated 11/14/2014 2:29:41 P.M. Eastern Standard Time,  
cmlhope@googlegroups.com writes:

Yahoo Greenie
So happy for you!!
Blessing
Jeanie

Sent from my iPhone

On Nov 11, 2014, at 4:05 PM, Myvety2k via CMLHope 
<_cmlhope@googlegroups.com_ (mailto:cmlhope@googlegroups.com) >  wrote:



 
I received my results back from my 6 month blood work  today and I'm 
Negative on BCR-ABL.
 
greenie
 
 
In a message dated 11/11/2014 2:14:49 P.M. Eastern Standard Time, 
_cmlhope@googlegroups.com_ (mailto:cmlhope@googlegroups.com)   writes:

Happy Veterans Day to all
JeanieđŸŒČđŸ‡ș🇾đŸ‡ș🇾

Sent from my iPhone

On Nov 11, 2014, at 1:56 PM, Myvety2k via CMLHope 
<_cmlhope@googlegroups.com_ (mailto:cmlhope@googlegroups.com) >  wrote:



 
Thank you Elizabeth,  I served 6 years in the  Navy.
 
greenie
 
 
In a message dated 11/11/2014 1:43:34 P.M. Eastern Standard Time,  
_ksnwoods@prodigy.net_ (mailto:ksnwo...@prodigy.net)   writes:

 
Thinking of you all.  Nick is critically anemic due to  Gleevec.  Hope 
Richard H., Shannon, Bobbie Doyle, and all  keep  up your sharing of info.  
thanks so much Marty for the  reports from the clinical trials to reduce or 
stop 
Gleevec.   
Thank  you to all Veterans on this day.  Elizabeth Woods




 
 
On Tuesday, November 11, 2014  4:32 AM, "_cmlhope@googlegroups.com_ 
(mailto:cmlhope@googlegroups.com) "  <_cmlhope@googlegroups.com_ 
(mailto:cmlhope@googlegroups.com) >  wrote:




 
 
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    *   _Glivec and studies of stopping the drug_ 
(https://us-mg205.mail.yahoo.com/neo/launch?.partner=sbc&.rand=8fv0d9j9nknkk#group_thread_0)
  - 1 
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 () _Glivec and studies of stopping the drug  _ 
(http://groups.google.com/group/cmlhope/t/839da881a2e6e455?utm_source=digest&utm_medium=email)
 
Richard H  <_rbhuffman1@gmail.com_ (mailto:rbhuffm...@gmail.com) >:  Nov 10 
09:05PM -0800 

Yes. This was the reason I  stopped Gleevec. I was also had Iron Deficient 
Anemia. I had  to infuse the iron to help try to recover my RBC count  
because was below 9. I was also still taking Gleevec while  doing this. 
On Monday, November 10, 2014 12:56:18 AM UTC-6,  Shannon L wrote:
_Back to top_ 
(https://us-mg205.mail.yahoo.com/neo/launch?.partner=sbc&.rand=8fv0d9j9nknkk#digest_top)
  
 () _Digest for cmlhope@googlegroups.com - 6  updates in 2 topics _ 
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ium=email) 
"Sue" <_hol...@iinet.net.au_ (mailto:hol...@iinet.net.au) >:  Nov 10 
07:13PM +0800 

Hi Shannon  



There is also the Destiny Trial in  the UK which is reduction down to 200mg 
for 12 months and then  stop (there has been no report until after Dec 
2014)  

The next Trial is named Spirit3 to see if people  are being over medicated 



The  Australian Survey will have 600 participants  



Sue  Hurt

(Australian)



From:  _cmlhope@googlegroups.com_ (mailto:cmlhope@googlegroups.com)   
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Sent: Monday, 10 November 2014 6:22 PM
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*  Glivec and studies of stopping the drug - 5 Updates  

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<http://groups.google.com/group/cmlhope/t/839da881a2e6e455?utm_source=digest
&utm_medium=email>  Glivec and studies of stopping the drug  


Shannon L <_shannonl.camden@gmail.com_ (mailto:shannonl.cam...@gmail.com)   
<mailto:shannonl.cam...@gmail.com>  >: Nov 09 03:58AM -0800 

Hi All My name is  Shannon I live in Sydney Australia
Its been awhile since I  have posted.
I was diagnosed 1998 and after a few years went  onto sti571 (glivec) and 
achieved remission within 2 months  and I have been it ever since about 14 
yrs.
They are  inviting participants (in Australia) to take a survey of  
stopping 
glivec I image they will do a study of stopping the  drug.
My question is does everyone know of the study done in  USA of the stats of 
stopping they have indicated in this  survey info that the percentage of 
success is 30-40% to me  that SEEMS LOW what do you think.
I do have some problems but  I am stable on glivec.
I hope this emil finds everyone  well
Shannon


Marty Gartenberg <_wa2yyx@gmail.com_ (mailto:wa2...@gmail.com)  
<mailto:wa2...@gmail.com>  >: Nov 09 07:46AM -0500 

Hi Shannon, there is a  study called the STIM that is going on in the UK and
it talks  about Imatinib being stopped. It is kind of lengthily however  it
does go into detail.
Good luck to you, and I have  always said there will be a cure for CML in
our  lifetimes.
If you follow any of my posts I always end them  with two numbers. They are
18 which is the symbol for  life.
18's to you Shannon
Marty
PS Shannon I encourage  you to post any time that you like. There will
usually be  someone that may be able to answer your questions. Besides  that
we are all here to learn from and help each other
Can  Imatinib Be Stopped?

Goodwin, Peter
Article  Outline
[image: Collapse Box]Author Information

ASH  Abstracts 186 and 187

SAN FRANCISCO—The early promise of  the tyrosine kinase inhibitor (TKI)
imatinib for treating  chronic myeloid leukemia (CML) has continued to be
fulfilled  following the release of seven-year follow-up data at the  ASH
Annual Meeting here from the International Randomized  Study of Interferon
versus STI 571 (imatinib) (IRIS) with 553  patients.

With diminishing rates of progression each year  beyond year three, the case
for stopping imatinib altogether  was also discussed at the meeting
following release of  results from two studies in which the drug was
discontinued  among patients who had achieved enduring complete  molecular
responses to it for more than two  years.

IRIS investigator Stephen G. O'Brien MD, PhD,  Senior Lecturer in
Experimental Hematology at Northern  Institute for Cancer Research of
University of Newcastle upon  Tyne, UK, gave the latest IRIS results to a
packed audience  at the meeting, showing an event-free survival rate of  
81%,
freedom from progression to accelerated phase/blast  crisis of 93%, and an
estimated overall survival rate of 86%,  from the standard dose of 400 mg
imatinib daily.

And  in the presentation that followed, François-Xavier Mahon, MD,  
Professor
at Victor SĂ©galen University in Bordeaux, France,  released early data from
the Stop Imatinib (STIM) study,  noting that remissions continued in about
half of the  patients after investigational discontinuation of  imatinib
therapy—with a non-significant trend showing that  patients previously
treated with interferon were more likely  to be among those whose remissions
persisted without  drugs.

Dr. O'Brien said that in IRIS the projected  cytogenetic response rate to
imatinib (by Kaplan Meyer  analysis) was 82%, and that after seven years of
follow-up  60% of patients were still on imatinib, with 57% of all  patients
still in complete cytogenetic response  (CCR).

The impression that CCR holds the key to a “cure”  of CML was strengthened
by comments he made after his  talk:

“It seems that if you maintain your CCR for, say,  three years, the chance
of regressing at that point is  essentially zero. So, achieving a CCR is, I
guess, what we  call a ‘safe haven’ for the majority of patients: If  
you've
achieved that and sustained it for, say, three years,  you're in pretty good
shape and the chance of progressing is  virtually nil,” he said.
Back to Top
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_
Stopped_.1.aspx#  
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx>
  >
| Article Outline
Diminishing Rates of  Relapse

These words reflect the diminishing rates of  relapse observed in the IRIS
study in successive years. Rates  of progression to accelerate phase or
blast crisis each year  were low at all times—with rates rising in the first
two  years (1.5% in the first year; 2.8% in the second year) and  then
diminishing after that (1.6%, 0.9%, 0.5%, 0%, 0.4% in  years 3, 4, 5, 6, and
7, respectively)—with only a single  patient having disease progression to
accelerate phase or  blast crisis between years six and seven.
[image: Figure.  FRANOIS-XAVI...]
Figure. FRANOIS-XAVI...
Image  Tools

The total annual event rates, including loss of  molecular complete
remission and death, were similarly low  (3.3% and 7.5%) in years one and
two, and diminished  thereafter (4.8%, 1.7%, 0.8%, 0.3%, and 2.0% in years
three  through seven).

These data only apply, of course, to the  majority of patients who prove
sensitive to imatinib, and Dr.  O'Brien noted that many patients who are
resistant or  refractory to the TKI are now candidates for other drugs  and
in some cases, allogeneic transplantation.

Dr.  O'Brien summed up his feelings about the current state of the  art
concerning imatinib therapy for CML: “I think it's  encouraging on two
fronts. One is that there's nothing new in  years six and seven to cause
alarm in terms of safety events.  And the second is—particularly in patients
who achieved a  complete cytogenetic response—I think we can be  very
reassured that the vast majority—especially if you have  that CCR for three
years—are doing extremely well, with very  few of those progressing.”
Back to Top
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_
Stopped_.1.aspx#  
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx>
  >
| Article Outline
STIM Study

Encouraging data  on long-term remission of CML among patients treated  with
imatinib gave rise to the French initiative to conduct a  pilot study with
15 patients looking at stopping imatinib,  and following this the
multicenter STIM study with 50  patients, which began in July 2007 but which
has already  yielded early—but provocative—evidence that remission from  
CML
can continue even after imatinib is stopped.

Dr.  Mahon said that patients were recruited into these studies only  if 
they
had received imatinib for at least three years and  achieved sustained
complete molecular remission (CMR) for two  years before experimentally
stopping the drug.

The  definition of sustained CMR was strict: BCR-ABL/ABL had to be  below a
detection threshold corresponding to a 5-log  reduction (undetectable signal
using RQ-PCR) for at least two  years. Molecular relapse was defined as
RQ-PCR positivity  detected in two successive assays, and patients who
relapsed  were then retreated with imatinib (successfully) at a dose of  400
mg daily.

In the latest follow-up of the pilot  study, Dr. Mahon said that seven out
of 15 patients had  relapse within six months and all were restored to CMR
by  re-treatment with imatinib. The remaining eight patients were  still in
CMR a median of 37 months after stopping the  drug.

All of the patients in the pilot study had been  treated with interferon
before receiving imatinib, most of  them responding to it. This raised the
suggestion—which Dr.  Mahon discussed in his talk at the ASH  meeting—that
interferon may have conferred a benefit among  patients who were
subsequently treated with  imatinib.

Half of the patients in the STIM study had been  pretreated with interferon,
and some provocative—but as yet  not statistically significant—data have
emerged showing an  advantage among those who had previously received
interferon  before going on to imatinib therapy.

By July 2008, 10 of  the 15 patients who were still in CMR had received
prior  interferon. The latest assessment from a slide Dr. Mahon  presented
showed that 27 out of 49 patients followed for more  than six months had had
disease relapse; 14 of these had  received only imatinib and the remaining
13 had been  previously treated with interferon, while only two of the  
seven
patients in STIM who have so far continued in CMR for  14 months had been
treated with imatinib alone.

Dr.  Mahon summed up his interim conclusions by stating that they  have
confirmed that CMR can be sustained after stopping  imatinib, and that
although there seems to be an [as yet  statistically unconfirmed] advantage
among the patients who  received interferon, it is possible to stop the drug
in  patients with sustained CMR even among those treated with  imatinib 
alone.

He reported that the probability of  survival without molecular relapse nine
months after  discontinuing imatinib was 46%, with the curve looking  flat,
so far, out to 15 months. Importantly, the STIM study  found that all
patients were sensitive after imatinib  re-challenge.
Back to Top
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_
Stopped_.1.aspx#  
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx>
  >
| Article Outline
‘Recurring Question’

When  Dr. O'Brien was asked for a comment on Dr. Mahon's conclusion  from 
the
initial pilot study and the early results from the  STIM study, he said,
“I'm fascinated by it. There's probably  a bit of a cultural difference, I
think, because most of my  patients in the UK—when I suggest
[stopping]—don't want to  hand their pills back, and want to carry on.
[image: Figure.  STEPHEN G. O...]
Figure. STEPHEN G. O...
Image  Tools

“I think that's driven by the fact that they are  tolerating the drug well.
There are no safety concerns  emerging with the long-term follow-up. And
it's obviously  having good efficacy in them. But this is a  recurring
question that I think we'll see more and more  of—and the French study is
very important.”
Back to  Top
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_
Stopped_.1.aspx#  
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx>
  >
| Article Outline
Low Toxicities

In the UK, he  noted, the preference for continuing imatinib could  be
explained by relatively low toxicities, which were not a  significant
barrier to its use, with neutropenia and  thrombocytopenia being minor
toxicities that are merely  irritating over time.

“GI toxicity like diarrhea, for  example, and a feeling of fatigue and
malaise, sometimes, and  muscle cramps can be troublesome in some patients
over the  years. But they're usually minor toxicities which, after  many
years, become rather wearing, rather than major  toxicities,” he said.

The bottom line for clinicians  treating their patients with CML, according
to Dr. O'Brien's  interpretation of his IRIS results, is that imatinib at
400  mg remains the current standard for first-line drug therapy,  even
though there are exciting data among patient cohorts  treated with nilotinib
and dasatinib first-line, with  cytogenetic response rates in excess of 95%.

“I think—for  the future—where we're going is to do comparative Phase  III
studies with the tyrosine kinase inhibitors in newly  diagnosed patients to
see if we can improve on imatinib.  Because although the imatinib data is
reassuring, it's clear  that at six or seven years, perhaps a third of
patients are  not continuing on imatinib,” he said.

*Supported by  funding from Genentech BioOncology and Biogen Idec.*

©  2009 Lippincott Williams & Wilkins,  Inc.



Shannon L <_shannonl.camden@gmail.com_ (mailto:shannonl.cam...@gmail.com)   
<mailto:shannonl.cam...@gmail.com>  >: Nov 09 03:52PM -0800 

Hi Everyone
Thankyou  Marty for the research information it was very informative, so  
they are combining stopping with interferon unfortunately I  can't tolerate 
it I remember the first time before  glivec.
I hope everyone is having a wonderful day.

On  Sunday, November 9, 2014 10:58:55 PM UTC+11, Shannon L  wrote:


Richard H <_rbhuffman1@gmail.com_ (mailto:rbhuffm...@gmail.com)   
<mailto:rbhuffm...@gmail.com>  >: Nov 09 09:33PM -0800 

What a great record.  You didn't indicate how much Gleevec you are taking. 
I have  read that several CMLers are taking reduced amounts and reaming  in 
remission. I have seen a post by a lady that said see was  very petite and 
she was only taking 100mg instead of 400mg.  
I don't know the percentage or of a combined results From  the different 
studies I read sometime ago I believe the  range you have is consistent 
with 
what I have read. You can  read my results below. My ONC told be I needed 
to end my  almost 6 year vacation and I am trying to requalify for a lower  
copay for Bosutinib. I have tested and they found no  mutation. I have 
studied the side effects and I will be  meeting with a Nurse to go over the 
side effects. Due to my  other problems I am concerned about all the 
interactions  with those Meds. 
I hope this has helped you.

Richard  H.

Dxd 2/2003 

400mg Gleevec  3/2003

Undetectable 11/03

RT-PCR negative  11/04

QT-PCR .003 11/05

RBC 8.

Gleevec  Vacation 11/06-6/07 

Iron infusion  11/06

Transfusions 12/06-5/07

QT-PCR  .007

Gleevec 1/08 -5/08

Procrit 8/08-11/08  

Gleevec Vacation 7/08-Present

QT-PCR .003  4/09

QT-PCR .0015 6/09

QT-PCR .0021  9/09

QT-PCR .0028 1/10

QT-PCR .001  4/10

QT-PCR .00468 10/10

QT-PCR 1.049%  2/11

QT-PCR .0612% 8/11

QT-PCR 2.616 %  2/12

QT-PCR 2.410% 8/12

RT-PCR 9.183%  4/13

RT-PCR 4.57% 6/13

RT-PCR 10.183%  10/13

RT-PCR 10.577% 2/14

RT-PCR 16.050%  5/14

On Sunday, November 9, 2014 5:58:55 AM UTC-6,  Shannon L wrote:



Shannon L <_shannonl.camden@gmail.com_ (mailto:shannonl.cam...@gmail.com)   
<mailto:shannonl.cam...@gmail.com>  >: Nov 09 10:56PM -0800 

Hi Richard H

Yes  Glivec 400 mg has been good to me I have been very stable on the  
drug, 
Wow 6 years off glivec thank you so much for sharing  your results just a 
question in your first holiday off  glivec you had an iron injection is 
this 
because of cml? I  am contemplating a small break as my stomach problems 
seem  to be increasing and are at times very debilitating. I know I  have 
been on many meds prior to glivec (chemo twice,  cytarabine, hydroxia, and 
interferon) and Im sure my body  sometimes struggles with it all.

On Sunday, November 9,  2014 10:58:55 PM UTC+11, Shannon L wrote:

Back to  top 

<http://groups.google.com/group/cmlhope/t/22ca310a00448c54?utm_source=digest
&utm_medium=email>  Glivec and studies of stopping the drug  


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Nov 09 07:32AM -0500 
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