Options in the face of rising counts -

July 6, 2005

Hi

I hate to say it, but your docs aren't overreacting. Your CML cells are

almost certainly becoming resistant to IM, the only alternative being that

you are somehow not absorbing it well or that you're metabolizing it too

fast - and both of these are very unlikely. So moving toward either the BMS

or AMN trial is clearly a good idea - and without delay, if I were you. I

wouldn't say this if your qPCR numbers were merely failing to improve, but

steadily rising counts can be an ominous sign.

Covering your bases on the transplant option is also prudent, it seems to

me, not only by ascertaining that you have a perfect match (as you've done),

but by preparing yourself emotionally to move toward SCT quickly in case you

show signs of acceleration. Transplants aren't fun, but they work (better

and better, in fact), and remain a great backup in this remarkable era of

drug treatment.

Best wishes,

R

> Date: Sat, 02 Jul 2005 02:20:27 -0000

> From: " lmperry05 " <lmperry05@...>

> Subject: Re: more IM / BMS trial

>

> I'm usually more of a lurker than a poster, but I'm hoping for some input

> for a change. It's just been 2 years since my diagnosis and my first year

> on 400mgs of Gleevec was uneventful. I've tolerated it very well and was

> living my life just like before being diagnosed with CML. After setting a

> baseline of qpcr results my doctor at City of Hope has become concerned with

> my ever rising numbers. I only once had a log reduction and now in my

> second year I continue to go up. She increased me to 600 mgs 5 months ago

> with no response. In fact I went up another log. My last FISH now has come

> back 11% ph positive and she wants me to start 800mgs. She wants me to see

> Dr. Sawyers at UCLA and try to get into the BMS trial too. She also said

> the AMN trial is coming to City of Hope soon so that's an option as well.

> It's hard to imagine that I'm resisting Gleevec but that's what she's afraid

> is happening. My sister is a perfect match so the opinion of the doctors

> there is to consider transplant but I'm very adament about that being my

> last option. Hate all this attention being drawn to my health especially

> when I still feel so healthy. I feel they're over- reacting. Am I in

> denial? Thanks all for listening.

>

> dx 5/03

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