PCR@21 MONTHS

consider switching drugs ("confuse" your CML). You are on a relatively high dose of imatinib. How are the side effects?

At your stage, switching to dasatnib (mid-dose 50 (or lower) mg NOT 100 mg) could very well cause your PCR to plummet at least one log down. Studies have shown when imatinib plateaus occur, switching to another drug can attack the residual cells not affected by imatinib. Your immediate goal is to get below 0.1% which you are close to achieving. You could wait until next PCR to see if your trend down is continuing or if you have leveled off. Either way, switching drugs can take you to the next step - and with less side effects. Nilotinib and Bosutinib are also practical alternatives. I suggest dasatnib because it works very differently that the others and attacks CML higher up in the cell hierarchy. It's likely to 'mop' up what imatinib is not getting.

Overall - our goal with TKI's is to find the one that works the best at the lowest dose.

If your doctor is willing to switch you to dasatinib, but only full 100 mg dose, I would decline.

Have you had mutation testing? Just wondering because our numbers are similar and I switched to Nilotinib from Dasatinib. Not a lot of research for 2nd gen TKI to another 2nd gen as most people switch from Imatinib. I agree with Scuba and think your numbers may well plummet on Dasatinib. I wanted to stay on it because I had no side effects beyond the first month. Have not had any on Nilotinib either except for what I have heard referred to as chicken skin (like goose bumps). Not terrible and I will probably get something for it. Hope your numbers plummet soon.

100mg Sprycel

23% (3 mo.)
1.9%(6mo)
0.81%(9mo)
0.32%(12mo)
0.58%(15mo)
0.111%(16mo via bmb)
1.2%(18mo ????. Possible lab error but wont know as I switched to Notinib without a bmb)
(21mo.......)