Stopping dasatinib

I would say that stopping treatment in any case with the exception of a controlled trial to go treatment free is not a good plan.  If your blood count is going low with dasatinib there are other TKI's that may be better for you.  Not taking the treatment and assuming that your blasts will remain where they were when you were on treatment is not a safe assumption.  It is however safe to assume that your cml is "growing" when off the treatment because it was designed to stop the bad cells from growing.  Perhaps a reduction in dose (70mg or 50mg) will allow you to stay on the treatment and not have such drastic drops in blood counts?  Taking the treatment is critical for better outcomes.  Hope this helps.  I am not a professional but l think my recommendation is good.

My blast shows of 24% and started dasatinib 100 mg. Dasatinib will be able to decrease my blast down to below 10? I am having bmt very soon. I was doing so well and all of sudden black clouds. My blast was 01% and because of low blood count doc suggest me to stop fie few days. I stopped for around 10 days and started since yesterday. My question within these 10 days blast can go this high? I am so so confused right now. 

Kirk

blast was shown in peripheral blood. I was diagnosed in june 2018 borderline of accelerated phase. I was taking imatinib for four months. Regular blood test was ok. But all of a sudden i start getting fever. Blood test showed blast in my blood. Doc change me to dasatinib along with chemo. I was back to chronic phase with 1% blast. But then slowly my blood count began to drop and doc advice me to stop drug. But after ten days i did peripheral blood smear and shows blast again. I was put back on dasatinib 100 mg. Yes i am about to have my bmt. My concern only within 10 days off medication wbc count and blast can go high like this?

What is your blast cell percentage currently? As long as your blast cell count is less than 5% you have some time to work through this. Bone marrow transplant is a last resort before trying other things first.

I went through similar events as you. Imatinib did not work for me. My blast cells were over 8% and rising. I was switched to dasatinib and my blood counts tanked. I was taken off dasatinib in a series of off then on pulsing treatment to get me used to dasatinib. This is what your doctor should be attempting with you.

However - there are a few things you can do during (and probably after) this transition as you manage blood counts and dasatinib.

1. Get your vitamin D level checked - chances are you are very low. vitamin D is required in order for blast cells to differentiate. Once I raised my vitamin D level over 50 ng/ml (by taking 5,000 - 10,000 IU's per day with fat), blast cell count went to zero.

https://www.ncbi.nlm.nih.gov/pubmed/18844838

2. Consider Curcumin (6-8 grams per day). Curcumin 'slows' CML and could assist in buying you more time.

Finally - 100 mg dasatinib is too high if you are experiencing severe low blood counts (myelosuppression). My doctor decreased my dose steadily until there was a balance between dose and cell counts (no more suppression).

I went from accelerated phase with lots of blasts to zero blasts, PCRU (undetected) and I take 20 mg dasatinib. I was never prescribed 100 mg., but it was a rocky first year and a half.

Discuss with your doctor and invite him to reach out to Dr. Cortes. If he doesn't know who Dr. Cortes is - you may need another more qualified CML doctor.

Thanks scuba

what Would be the best time to take vitamin d3 supplements and with what food. I usually take dasatinib around 6 pm.