Hi, this is my first post. I'm diagnosed in october 2016. Start with Imatinib 400 at 22%, after 3 months 0.27%, now after 6 months 0.012%. I would like to ask my docter to reduce my dose to 200mg, but I think this is really soon. But I hope my side effects will be less then. Has anyone experience with reducing so soon? Thanks!
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reducing dosage within a year after diagnose
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First of all well done on some great results and the speed they have come, really good. A couple of points I would make; first of all it is a little early for does reduction in my view as yet, generally, other than due to side effects full dose is maintained for a couple of years, so levels get very low and under control for several PCR results so the trend has been set.
Secondly, Imatinib is not as powerful a TKI as the other newer drugs, and so 400mg seems to be the optimum dose for benefit, whereas with Dasatinib and Nilotinib for example lower doses given their strength do work well still. I know in the UK we have had the DESTINY trial where ½ dose was given under strict supervision but this was when patients were around MR4, and below for at least a couple of years, and patients had monthly PCR testing. Some Doctors felt there was a risk with Imatinib at 200mg as it may be ineffectual at such low levels and so may actually not give any benefit, eg patients may as well have stopped treatment.
If you are well, and the side effects bearable then personally I would stay on full dose, at least for some time yet. If the side effects are bad, then perhaps a change of TKI may do the trick in reducing these. I know destiny dose go against my thoughts but as many did well on ½ dose, I did, making 1 year, but in this year I did see my levels gradually rise, until all of a sudden they jumped up. Full dose soon brought these down though. All the best for continuing great results NIgel