Discouraging Polymerase Chain Reaction Test Realization

It has been three months since my doctor increased my dosage of Sprycel from 100 mg, six days a week, to 140 mg, five days a week. That is an increase of 100 mg a week; not much, but my doctor prefers to take a cautious approach for two reasons. The first reason is to avoid toxicity; the second is to give me the best possible response, with the least amount of side effects. In other words, he wishes to give me the longest and best quality of life. 

Needless to say, I was anxiously awaiting the results of my PCR Test after being on this regime for three months. My doctor, as well as myself, expected nothing other than a decrease in my Bcr-Abl. Unfortunately that was not the case. I actually only had a slight decrease from 3.89 to 3.49 x 10-4, which is almost exactly where I was one year ago, in October of 2011, at 3.99 x 10-4. What? One year down the road and in the same place?

This realization is quite discouraging; I have followed doctor’s orders to a “T”, I have taken every dose of Sprycel, on time for the past year, and I am exactly where I started. I am at square one, taking more medication than I had hoped to be taking at this point. I now look back and wonder whether or not I should have questioned my very first doctor when he started my treatment with the highest, possible dose of Sprycel. He was not a CML specialist, so he was simply reading the guidelines for someone in the acute phase of chronic myelogenous leukemia, not the chronic phase, which it was determined, despite my 385,000 white cell count, that I was in. Maybe he knew what he was doing!

My subsequent doctors did decrease my dosage of Sprycel to a more therapeutic level, but evidently either my bone marrow has figured out a way around the drug, or my Bcr-Abl genes are particularly stubborn. I am hoping and praying that I do not have a mutation going on, and that my NEW regime of 140 mg of Sprycel, six days a week will do the trick. My doctor is of the mind that my body may simply be taking its’ time in responding to my increased dosage.

So, for now, I will take my medication, like a big girl, six days a week, and hope and pray that come the New Year, I will have good news. I will do my best to not dwell on the fact that I am starting the second leg of my race, all over. This time, I plan to come in First Place!


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