Good afternoon, background, I was diagnosed 1 year and 6 months ago, with 400 mg of imatinib to date, I am 23 years old, the first year of treatment was slow, but after 1 year and 3 months it picked up speed and I reached the state of complete molecular remission of the disease.
The last month has been complicated, first of all due to a permanent and sometimes very intense facial reddening of the skin, I have been to the dermatologist, laser-pulsed light treatment, many creams, antihistamines (in case it was an allergy) and now I am also taking Carvelidol, a beta-blocker that helps reduce redness since it reduces tension. Nothing has barely given me any results. Has anyone experienced something similar? Any ideas? I knew that imatinib could influence this, although my doctor thinks it is strange since I had been without it for 1 year and 4 months, and I would not want to change it
The second thing is that I recently received the routine tests, the others have not yet, and in addition to having decreased iron, the most striking thing has been a very large increase in eosinophils that I have at 1.3 when normal values are 0.04 -0.5, the rest of the parameters remain similar with respect to the analyzes of 3 months ago, but this is especially striking, if anyone has any ideas or information regarding this topic, it would be appreciated, greetings.
You are here
very high eosinophils, permanent skin redness and doubts
It seems you may be having a significant allergic reaction to imatinib
Eosinophils increasing is a reaction.
Given that you responded well to imatinib, you might consider changing drugs (dasatninb or other) and lowering starting dose (50 mg). Consult with your doctor that you believe you have become allergic to imatinib and would like to switch. Developing an allergy over time is very possible. As your blood system recovered and became more normal again, new immune cells are at work (including eosinophils) compared to leukemic ones and they don't like imatinib.
You could stop therapy for a few weeks and see if the allergy clears up. If it does you have your answer. No risk of CML coming back suddenly in just a few weeks time. CML is a slow disease at your current level (CMR). Chances are it may clear up after just a few days off drug. You can restart drug and see if it comes back. It's likely it will.
Hello, thanks for the answer, I am still with imatinib today, it seems that the skin has improved slightly due to the temperature balance, when I have more redness it is with temperature contrasts among other things, we do not know if it is a direct allergy to imatinib or that my skin has become so sensitized that it is hyperreactive to triggers, as soon as I notice that it gets worse again I will withdraw imatinib to see the results, which by the way, the CRP has risen from 0.009 to 0.01, from month 15 to month 18, I do not know to what extent it is normal, he told me that I am at the limit of the molecular response, I had understood that the limit was 0.1, it was not entirely clear to me, thanks again.
"by the way, the CRP has risen from 0.009 to 0.01, from month 15 to month 18"
The difference between 0.009 and 0.01 is 0.001. PCR precision is one log (power of 10). And that is when PCR measurements are above 0.1%.
In other words, the difference you report is insignificant and within the noise of the test. I could take 5 PCR measurements from one blood sample and get 5 very different results all within one log (0.005 - 0.05). Many labs do not even report PCR's in the "third" decimal place.
Major molecular response is achieved at 0.1%. It's a definition for reporting purposes. There is nothing biochemical about that number. Your doctor, when saying you are at the limit of the molecular response, probably is meaning you are at the limit of the PCR test itself. You are borderline 'undetectable'. This is a very good place to be.
The odds of CML progressing into a life threatening disease, in your case, is near zero. I would say 'zero', but in science, nothing is 100%, but 99.99% no risk is pretty good odds.