I have a 27 yr old with CML initially treated with Imatinib on EPIC study but failed and was changed to dasatinib 100mg daily. He weighs about 130kg.
His PCR’s have plateaued at a warning level. His counts are normal….do I sit tight, increase the dose or change to Nilotinib?
CML; first chronic phase with Hb 87, WCC 434, blasts 17.4, promyelocytes 17.4, basophils 17.4, eosinophils 8.7, platelets 772, spleen 27cm below costal margin; treated with Hydroxyurea from 28 March 2013, EURO 1,612 high risk, SOKAL 2.0 high risk; treated with Imatinib on EPIC study; restaging with a six month bone marrow which showed 100% CML positive cells by FISH, started Dasatinib 25 October 2013
Quantitative RT-PCR analysis for bcr-abl
April 2013 = 177.8% (IS)
Feb 2014 = 7.66% (IS)
May 2014 = 2.04% (IS)
Aug 2014 = 1.45% (IS)
Nov 2014 = 1.12% (IS)
Mar 2015 = 0.840% (IS)
July 2015 = 0.381% (IS)
Sep 2015 = 0.323% (IS)
Oct 2015 = 0.495% (IS)
Feb 2016 = 0.420% (IS)
Aug 2016 = 0.419% (IS)