Q
: 1
07/27/2010 |
I was diagnosed at age 52 with CMML in '09 and completed 6 mos. in of chemo. Recent bone marrow biopsy showed increased monocytosis, 3-5% blasts. No genetic mutations, most everything else normal. How long does watching and waiting go on before you need to consider more chemo or bone marrow transplant? How long can I expect to live if we do nothing?
Some investigators have attempted to formulate prognostic models that take characteristics of the CMML and then give survival predictions (see M Beran et al. Leukemia and Lymphoma, June 2007; 48(6): 1150-1160). However even for "low risk" patients, the average survival is significantly shorter than it should be. As such, I would recommend that bone marrow transplantation be explored now to see if you may have a well-matched sibling or unrelated donor transplant option.
|
Q
: 2
03/03/2010 |
Is there an effective treatment for severe systemic itching associated with CMML?
You can try 4 mg of Periactin three times per day, and/or doxepin (25 mg?) at night. Also, effective treatment for the CMML should help.
|
Q
: 3
03/01/2010 |
My grandfather has Mantel cell lymphoma and has undergone
three different chemotherapy treatments, all of which were
unsuccessful. The condition has started to worsen in his
groin area. The swelling of the lymph nodes has caused his
entire right leg to swell. This causes extreme discomfort and pain. What other treatments are available and which do you recommend?
You should speak with his doctor and see if they would consider radiation therapy to the groin area for symptom management. For systemic therapy consider either Rituxan + bortezomib or Rituxan + bendamustine if these haven't been used before.
|
Q
: 4
11/01/2009 |
My Husband was recently diagnosed with CML and has started on Imatinib, once daily. He has had mild side effects like headache and fatigue. Is this normal? Can he take ibuprofen for these headaches? Also, we don't have any children and I was wondering if this treatment would negatively effect our chances to conceive.
I think he can take ibuprofen for headaches, but Tylenol is also OK. Imatinib is generally well-tolerated. It is important to monitor the blood counts during treatment with Imatinib as they sometimes can go down. Generally it is advisable to continue the medicine as long as your husband is responding well to it. However, if he has a very good (molecular) remission, it may be possible to stop it for a period of time to increase the chances for successful conception. Perhaps he could even go to a fertility clinic to have sperm testing during the Imatinib treatment to see if there has been any effect on sperm count, etc.
|
Q
: 5
09/04/2009 |
I know a 48-year-old male firefighter with CML and he is concerned that his years of firefighting caused or contributed to his disease. Is this likely?
No, I don't think so. I am not aware of any connection between the two. CML is caused by a genetic change (actually a chromosomal rearrangement) in the abnormal leukemic cells. Exposure to strong radiation (for example atomic bomb victims in Hiroshima) might increase the risk, but I'm not aware of any contribution from exposures during normal firefighting work.
|
Q
: 6
06/30/2009 |
I was diagnosed with CML in August 2008 and immediately started taking Gleevec and have had a really good response. Recently, I have been experiencing worsening side effects including abdominal swelling. I stopped taking Gleevec and the swelling went down noticeably. My oncologist has suggested that I stay off of it for another week. Is it a terrible idea to not treat my CML at all for two weeks?
I don't think that a two week break is a problem, especially since it seems that you had a very good response to Gleevec. Thus, your burden of CML should be very, very low. I would restart as soon as the symptoms are better and probably go back to a lower starting dose. If you were on 400 mg daily before, then try 200 mg or 300 mg initially.
|
Q
: 7
04/01/2009 |
My mother was diagnosed with CMML. Her platelets are low (about 12,000) which required her to receive a round of transfusions. Is it possible that Gleevec could be used in place of Hydroxyurea?
Gleevec is usually not effective against CMML (as opposed to CML). One exception is when the CMML is associated with a 5:12 chromosomal translocation/abnormality. This is uncommon in CMML but when present, could make the CMML responsive to Gleevec. Best of luck to you and your mother.
|
Q
: 8
02/17/2009 |
How long do people with CML live? I was diagnosed with CML 3 years ago and I have heard that people with CML don't usualy live longer than 5 years after being diagnosed. Is this true?
That is not true anymore. With the advent of new treatments, especially Gleevec and similar drugs, it is likely that more than 90% of patients live for more than 5 years after they've been diagnosed with CML and the vast majority live for more than 10 years after diagnosis.
|
Q
: 9
01/22/2009 |
I am taking Gleevec and feeling much better, but I have noticed that if I bump into anything I get a lump and have bruising that seems to be a little excessive. Could this be because of the CML or the Gleevec?
The lump and excessive bruising you have described could be caused by either the CML or the Gleevec. The best thing to do is to have your doctor check your platelet count.
|
Q
: 10
01/14/2009 |
I was recently diagnosed with CML. I have been taking Gleevec tablets and they have seemed to improve my health significantly. Although I am feeling better, I noticed that I have been bruising very easily. Do you have any suggestions on what I should do to improve my health even further? Is there a certain diet that I should be following?
First, be sure you get your blood counts checked regularly. It is possible that your platelet count may be a bit low if you are bruising easily. You should be eating a good balanced diet with lots of dietary fiber, vegetables and fruit, but also protein from meat, fish or chicken. Basically, you should be eating a good, healthy balanced diet. Glad to know that the Gleevec is helping so much. Best of luck to you.
|
Q
: 11
12/05/2008 |
My oncologist told me a year after I was diagnosed with CML that some test indicated that I would be resistant to Gleevec. It turns out that I'm not and I am responding to the treatment. I'm puzzled why I am just finding this fact out. I am doing well.
I'm not sure what that thing was that your doctor was worried about. But the most important thing is that you are responding well and I hope that you continue to do so.
|
Q
: 12
06/05/2008 |
My wife has recently been diagnosed with CML. She has started on Gleeve(400mg) for 2 weeks now, and her blood counts have come down to 24000. Now my question is, if she achieves a complete molecular response, is it possible to lower the dose or even stop Gleevec completely?
A complete molecular response is a highly worthwhile goal to achieve in this situation. If it is achieved (or even if a near complete response is achieved), I would not recommend stopping the gleevec, since the CML comes back in a majority of the patients. Even when the CML has been in a complete molecular remission for an extended period of time (say two years or so), stopping the gleevec will allow the CML to come back in at least 50% of the patients. Gleevec is an excellent treatment for CML, but not considered to be curative.
|
Q
: 13
06/19/2007 |
I am a 34-year-old male who was diagnosed with CML in 7/06. So far, I have had an excellent response with Gleevec. I met with my new oncologist last week and we were speaking generally regarding CML and Gleevec. He told me most oncologists believe everyone will eventually build up a resistance to Gleevec. This seemed contrary to what I've read or been told previously. Could I ask your thoughts on this?
While development of resistance to Gleevec is an important problem, the data to date do not support the notion that "everyone will eventually build a resistance". For patients in chronic phase (early phase) disease, the frequency of resistance is rather modest - about 10% at 5 years of followup. For patients who have molecular responses (greater than or equal to 3 log reductions in CML transcript levels)the likelihood of developing resistance appears to be even smaller. So remain hopeful and optimistic. Furthermore there are new agents for patients who do develop resistance to Gleevec, and bone marrow transplant still should be kept on the "back burner" for young individuals such as yourself.
|
Q
: 14
10/12/2006 |
My husband is 46 years old and was just diagnosed with chronic myelogenous leukemia a month ago. It was an accidental finding and he had no symptoms. He just started taking Gleevec. My question is what is the prognosis with treatment during the chronic phase? I am rather confused regarding the prognosis based on the literature I have read so far -- if prognosis is based on treatment or without any treatment.
Overall the prognosis in chronic phase is good WITH TREATMENT. Although Gleevec is not considered to be a cure, it produces complete chromosome responses in a majority of patients and even complete molecular responses in about 30% of patients. Its use is associated with better survival and improved disease control (i.e., delay of progression to more advanced stages of leukemia). Nonetheless, bone marrow or blood stem cell transplantation remains the only known curative treatment and should be used if the response to Gleevec is unsatisfactory or if the CML gets worse while a patient is on Gleevec. If your husband has brothers or sisters, they should be tissue typed to see if they are matches to him. Hope this helps. Best of luck to you both.
|
Q
: 15
09/24/2006 |
Is interferon alfa 2a or interferon beta-1a used in the treatment of CML?
Recombinant interferon alfa 2a. However there are better drugs now (e.g. Gleevec - Imatinib).
|
