Q: I was diagnosed with CML (Leukaemia) last year. I did not have any other problem except that I was in too much tension because of pending official and personal work. One night I felt uneasiness, unusual heartbeat, sweating and I felt that if I sleep I will die. I went for a check-up and it was found that my blood pressure was on the higher side and I was given sleeping pills. I had the same feeling again after two days, I went for a routine blood and other check ups. The report said that I was suffering from CML (chronic stage). How long can I survive with the current medicines I am using? Should I go for a bone marrow transplant? I have a 4-year-old son and I wish to have another child, should I go ahead or not?

A:I assume that you are around thirty years old since your son is 4 years old. You have not mentioned the name of the current medicines but I assume you are taking imatinib (veenat or glivec). The chances of your getting normal blood counts is more than 98%, getting major cytogenetic response (significant or total disappearance of Philadelphia chromosome) is over 85%. The complete molecular response (qt pr bcr-abl) is seen in less than 5% patients. Survival is expected to be several years, there is no data since the drug imatinib is available for only 2-3 years. While on this drug pregnancy can not be recommended officially, although reports of normal pregnancies are there. Bone marrow transplant is the only way to attempt a cure in CML, but the possibility of getting a suitable HLA matched sibling is about 30%. The risk to life for patient undergoing transplant is about 20% in 6 months. This is in contrast to little or no toxicity of imatinib. So, one has to make a choice at this age.