HI Choi,

This sounds very difficult. While your friend is not in molecular remission his 
blood work is stable..it has not spiked while on less sprycel. Is it possible 
he could go on 40 mgs or 40 five days a week and 60 two days a week? Sometimes 
just enough medication will keep the plural effusions at bay, while still 
keeping the cancer at bay as well. The risk is getting resistant, which he has 
already done with the Gleevec. But there are other options and another in 
trials that works in a different area than the other TKI's that is showing 
promise. So hopefully your friend can find the right med at the right dose to 
keep his disease in check. He may not tolerate full doses of the more recent 
and more potent meds..but there are several left to try. 
I can only tolerate 40 a day. Keeps me in check. I cannot go off med as I 
cannot take a high enough dose to get into that level of remission..but it 
works for me.


Others who did not tolerate Sprycel have gone on bosutinib and it has worked 
for them...


Take good care..


18's hope and love,




Beth 



-----Original Message-----
From: Jamie Tufariello <gex6...@gmail.com>
To: cmlhope <cmlhope@googlegroups.com>
Sent: Thu, Jan 25, 2018 10:44 am
Subject: Re: [CMLHope] off Sprycel




On Tuesday, June 9, 2015, Choi <saehyun...@naver.com> wrote:


Hi, this is Choi from South Korea. One of my CML friends had some problems and 
I just wonder who had a similar experience. 


He was diagnosed with CML chronic phase on july 2012 and started Gleevec 400mg 
for 16 months and switched to Sprycel due to E355G mutation. 
At that time his PCR was 1.89. He started Sprycel  and E355G mutaiton was 
disappered. He was on Sprycel for 12 months. 
He developed pleural effusions after 12 months of Sprycel at that time his dose 
was 100mg. His doctor stopped Sprycel for 2 weeks and restarted Sprycel 80mg 
for 3 months.
Once again he developed pleural effusions so he was off Sprycel for 4 weeks and 
restarted Sprycel 60mg until now and still had minor pleural effusions. 
PCR count was 0.37, 0.47, 0.45 and never drop to under 0.1% so his doctor was 
considering to switch to other drugs but hesitated to switch because of he had 
E355G mutation.
Is there any one who had a similar experience?


Choi. 

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