The guys in town are trying to get a handle on all of this to write an article 
in medical papers.  I do not like to make too big of a deal about this as I am 
getting up in years and like Zavie I could get something like the flu, everyone 
would blame CML and all the drugs I've been on so I would not want that.  No 
good to make CML a terrible problem when so many now are doing so well..  As 
you said there will be a cure.. so I will like all old soldiers fade away when 
its my time
       From: Marty Gartenberg <wa2...@gmail.com>
 To: cmlhope@googlegroups.com 
 Sent: Saturday, November 15, 2014 11:31 AM
 Subject: Re: [CMLHope] Digest for cmlhope@googlegroups.com - 2 updates in 2 
topics
   
 Hey Skip, you say "been on all the different chemos just like school I failed 
every one"
Well, you may have been on all of them but you didn't fail. And do you want to 
know why? Hey your still here after all of these years. 
I think that sending you those 18's really speaks volumes.
Skip you need to make awareness of CML as probably the longest person in the 
world alive with CML. Ever think about contacting the Guiness world book of 
records?
18's,
Marty


On Sat, Nov 15, 2014 at 8:46 AM, Myvety2k via CMLHope 
<cmlhope@googlegroups.com> wrote:

Marty, very well spoken. greenie In a message dated 11/15/2014 8:43:02 A.M. 
Eastern Standard Time, wa2...@gmail.com writes:
 Hi Greenie, 
 This ship that we are all in command of is a very special ship. Do you want to 
know why? Well, it is always afloat and never sinks. Even if you have some bad 
days, and I can certainly attest to that, then we also have those good days. So 
we seem to be sailing in the right direction. 
 My father once taught me that every day is a good day as long as none of our 
loved ones dies. I was in that plastic bubble when he came and sat right in 
front of it. I was kind of feeling really bad until he told me that. GOD rest 
his soul...  
 18's, 
 Marty 
 On Sat, Nov 15, 2014 at 7:20 AM, Myvety2k via CMLHope 
<cmlhope@googlegroups.com> wrote:
 
  Well thank you Marcie,  I have this idea, let's make Skip a Fleet Admiral, 
I'm not sure but I think he as had CML the longest. Will make Marty Admiral 
that's next in line and I'll be Captain Dave.  When I first started flying real 
planes my instructor used to call me Capt. Dave.  So when I started flying RC 
airplanes last year I crashed a lot so one of the guy's would call me Danger 
Dave.  Of course now I can fly as good as the rest of the guys.  But their used 
to be a lot of broken plane parts on the field.   greenie        In a message 
dated 11/14/2014 10:51:23 P.M. Eastern Standard Time, cmlhope@googlegroups.com 
writes: 
 Greenie, we are all so thrilled you are doing well. If Marty is our captain, I 
think you must be his first officer! 
 Marcie

Sent from my iPad 
On Nov 14, 2014, at 9:38 PM, Myvety2k via CMLHope <cmlhope@googlegroups.com> 
wrote:

 
  I would like to thank each and everyone of you for your warm hearted replies. 
  greenie    In a message dated 11/14/2014 9:36:20 P.M. Eastern Standard Time, 
cmlhope@googlegroups.com writes: 
 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> 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> 
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 writes: 
 Happy Veterans Day to all Jeanie🌲🇺🇸🇺🇸

Sent from my iPhone 
On Nov 11, 2014, at 1:56 PM, Myvety2k via CMLHope <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, 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" 
<cmlhope@googlegroups.com> wrote:


     
| cmlhope@googlegroups.com  | Google Groups  |   |

  Topic digest 
View all topics      
   - Glivec and studies of stopping the drug - 1 Update 
   - Digest for cmlhope@googlegroups.com - 6 updates in 2 topics - 1 Update 
 Glivec and studies of stopping the drug  
| Richard H <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  Digest for cmlhope@googlegroups.com - 6 updates in 2 topics  
| "Sue" <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] 
Sent: Monday, 10 November 2014 6:22 PM
To: Digest recipients
Subject: [CMLHope] Digest for cmlhope@googlegroups.com - 6 updates in 2 topics
 

 
 
cmlhope@googlegroups.com 
 
<https://groups.google.com/forum/?utm_source=digest&utm_medium=email/#!overview>
 Google Groups 
 
<https://groups.google.com/forum/?utm_source=digest&utm_medium=email/#!overview>
 
 
Topic digest 
View all topics 
 
* 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.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 <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 Ségalen 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.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 <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.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 
 
 
myvet...@aol.com <mailto:myvet...@aol.com> : Nov 09 07:32AM -0500 
 |

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[CMLHope]
A support group of http://cmlhope.com
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 -- 
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[CMLHope]
A support group of http://cmlhope.com
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You received this message because you are subscribed to the Google Groups 
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-- 
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[CMLHope]
A support group of http://cmlhope.com
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You received this message because you are subscribed to the Google Groups 
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-- 
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[CMLHope]
A support group of http://cmlhope.com
-------------------------------------------------
 
You received this message because you are subscribed to the Google Groups 
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[CMLHope]
A support group of http://cmlhope.com
-------------------------------------------------

You received this message because you are subscribed to the Google Groups 
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