Posted by: Mary Crocco | May 10, 2011

A good prognosis? Five years.

Gleevec:  Imatinib Mesylate

 November 2003


“Mary, you are in phase one of Chronic Myeloid Leukemia,” said Dr. Sanchez. This will sound callous, but this is the best time to get CML,” said Dr. Sanchez. Did he just say CML was good?  “Let me explain.  You have the advantage of trying a new drug called, Gleevec.  It is a pill that targets the number of abnormal white blood cells while leaving your healthy cells unharmed. You will not have to experience traditional chemo therapy.” So all I have to do is take a pill?

I contributed a blank stare and silence.  “Mary, Gleevec has demonstrated to effectively return blood cells to normal.  Today, a large percentage of CML patients who take Gleevec are surviving more than five years, said the doctor.  I only have five years to live?    “I will start you on 400mg. of Gleevec. I am going to give you literature to take home and read.

To confirm my diagnosis, Mary, I want to give you a bone marrow biopsy. This test will count and examine the cells that are harvested. I will examine the cells under a microscope.  The diagnosis of CML is confirmed if part of chromosome nine switched with part of chromosome 22.  This abnormal chromosome is called the Philadelphia chromosome.

I know this is a lot of information and a big shock, Mary.  Do you understand what I have explained?”  OK, let me get this straight. “Doctor, I have leukemia?” I asked.  “Yes, you are in phase one of Chronic Myeloid Leukemia,” said Dr. Sanchez.

“I can live for five more years taking this new drug? I forget the name of it,” I said.  “That’s right. If you take Gleevec, your prognosis is five years.  This is why it is a good time to get CML. People were dying pre-Gleevec. They had to endure bone marrow transplants with an uncertain prognosis. Gleevec, is an oral chemo therapy pill, which taken daily, offers CML patients a brighter future. It is a blessing it was discovered in phase one,” said the doctor.

“What happens when I take this Gleevec pill?” I asked.  “There are a lot of side effects, Mary.  Oh my god. We will take it one step at a time. I will give you a prescription today.  Pharmacies have to special order it because it is very expensive. Your insurance company needs time to approve it.

I want to perform the biopsy on Thursday. I will do it here in my office.  It takes ten to twenty minutes. I will withdraw bone marrow from your hip, your pelvic bone.  I will administer a local anesthetic where I inject a tiny needle. There is a sting and burning sensation,” explained Dr. Sanchez.

“The results will be ready by Tuesday.  If your pharmacy doesn’t have the prescription ready, I will get you started.  We will go over everything, Mary.  Here is the literature to read, in the meantime. All your concerns will be addressed on Thursday.  We will go over the side effects of Gleevec and you will feel comfortable living with CML.  Comfortable?

Shelly, Dr. Sanchez’s nurse, came into the room. She walked me out to set up the biopsy appointment for Thursday.  She told me the doctor only performs biopsies first thing in the morning. No Perfect Attendance this year.  We made the appointment for 8:30.

I passed a Terrible Herbst and decided my truck needed an oil change. I read literature with bold capital letters, CML, while getting high on toxic fumes.   I finished reading and thought, I have cancer. I have leukemia. I have CML.  I will have a bone marrow biopsy in two days. I will take Gleevec every day. I have five more years to live.   Cancer.  Leukemia.  CML.   I am sitting on my chair, I am home?

A five year prognosis.

  • The FDA approved Gleevec in 2001.
  • Gleevec costs about $5,000 a month.
  • The Philadelphia chromosome is named after the city where it was discovered.

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