Thank you Marty,  I should have added that I went into  remission within 6 
months after starting Gleevec.  I was having to get  blood work every 3 
months now I get blood work every 6 months.  I've  had 27 BMB's so I'm glad 
they 
do it by testing your blood. We all have our  good days and then their are 
a few bad days to so like my late Aunt used to say  just take one day at a 
time.  And that's what I do.  Today was one of  those bad days but tomorrow 
I'm sure will be better it always is. Everyone  please take care of 
yourself's I'm so lucky my wife Grace who takes good care of  me.
 
greenie
 
 
 
In a message dated 11/14/2014 7:35:36 P.M. Eastern Standard Time,  
wa2...@gmail.com writes:

Greenie,  


Hey, what took you so long? I am thrilled to hear this wonderful news.  You 
are blessed.


18's,


Marty


On Fri, Nov 14, 2014 at 2:29 PM, icandoallttc via  CMLHope 
<_cmlhope@googlegroups.com_ (mailto:cmlhope@googlegroups.com) > wrote:


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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Topic digest  
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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_ 
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_Digest for cmlhope@googlegroups.com - 6  updates in 2 topics _ 
(http://groups.google.com/group/cmlhope/t/6cf9af24d4b963a7?utm_source=digest&utm_medium=
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)  
[mailto:cmlhope@googlegroups.com] 
Sent:  Monday, 10 November 2014 6:22 PM
To: Digest  recipients
Subject: [CMLHope] Digest for _cmlhope@googlegroups.com_ 
(mailto:cmlhope@googlegroups.com)  - 6 updates in 2  topics




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*  Glivec and studies of stopping the drug - 5 Updates  

* Glivec and studies of stopping the drug - 1  Update 

<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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[CMLHope]
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