Q: My 30 years old wife is diagnosed with chronic myelogenous (or myeloid) leukaemia (CML) in CP few months back. She is taking Gleevec 400 mg per day. Her white blood cell (WBC) count is going down to 2000 from 3000 if she takes Gleevec continuously. The doctor recommended to stop Gleevec if the count goes down and to restart it once again when the count comes to normal i.e., (4000 ~ 11,000). Is it normal in the treatment with Gleevec? Is it life threatening? Will bone marrow transplant cure CML completely? Please advise.

A:It is not an uncommon that on Glivec therapy TLC goes down, because of its bone marrow toxicity (Myelotoxicity). If blood count goes down too much then patient needs dose modification - lower the dose. Many times too low blood counts (especially absolute neutrophil counts <500) are life threatening, because any infection can be fatal in this setting.

At present for CML, only curative treatment is bone marrow transplantation. Gleevac keeps disease in control with responsive disease.