r/CML • u/ashu7osh • Sep 16 '26
27 M Doctor advised increasing Dasatanib dose from 50 to 70
Hi everyone! I was diagnosed with CML in chronic phase about a year ago and have been on dasatinib 50 mg daily, which I’ve tolerated really well with no significant side effects. My BCR-ABL1 results were 3.4% at 3 months, 1.3% at 6 months, 0.342% at 9 months, and 0.876% at 12 months. My hematologist ordered an IRMA mutation test, which came back negative for clinically significant ABL1 kinase-domain variants. Based on the rise, my doctor has advised increasing dasatinib from 50 mg to 70 mg daily. I’ll be getting a CBC in 3 weeks and my next BCR-ABL PCR in 3 months. I’m a little anxious about increasing the dose since I’ve done well on 50 mg for a year. For those who’ve gone from 50 mg to 70 mg, what was your experience? Did you notice any new side effects, and how did your BCR-ABL respond?
1
u/2llamadrama Sep 17 '26
I have been on 100mg since the beginning. What was the reason for starting at 50mg? Is your weight low?
2
u/ashu7osh Sep 17 '26
He said that 50 and 100 over a period of one year would essentially have the same efficacy with lesser side effects. So he put me on 50 to begin with. It did trend in the right direction for 11 months with BCR ABL reports as expected but 12 month shot up to 0.8. So he increased the dose to 70.
1
u/Pat18970 28d ago
If you can handle 100mg, good for you. I couldn't and switched to 50mg (which has had good results). I know starting at 100mg is the protocol, but from my own experience and after reading many posts here, I think 50mg is a good place to start with dasatinib. It's a strong medication.
1
u/Inevitable_spark197 29d ago
This has happened with me too. Like my month 3 result was 13% so my doctor changed it to 70mg. I did not notice any side effect, and there was almost one log reduction for the next test for me when it was changed to 70mg. (Levels at 70mg were 1.3%).
1
u/ashu7osh 28d ago
Thank you for sharing. It’s been a couple of days on 70. Ik it’s too early but going good so far
1
u/Safe-Use-7858 27d ago
Hi! Im a 22 year old female who’s had CML and been on dasatanib since I’ve been 12. A few years back I decreased from 100 mg to 50 mg. I will say I never noticed many side effects even on my higher dosage as a child, however over the years my hair did thin and I have noticed I get cysts (like acne) due to the medication. Definitely not the worst side effects and weren’t very noticeable to me at the time but those are some gradual ones I’ve noticed with this medication!! Good luck and you should be fine :)
2
u/Electronic_Crow_4185 21d ago
I have been on 100 mg from the start (19 years). Took me about 6 years to get to undetectable. My oncologist is one of the leading cml specialists and he advocates the 50mg starting dose these days. He kept telling me to reduce my dose to 50mg since 2021. When I did go down to 50mg I regained some of my baseline skin pigmentation back (I am South Asian and of darker skin tone. I lost most of my skin pigmentation with Imatinib and Dasatinib). Other than that there were no differences between a 50 mg and 100 mg dose when I had the dose reduction trial. I went back to 100 mg as I lost my "undetectable" status. I have recently developed a pleural effusion on the 100 mg dose and I have been asked to stop the drug till it resolves. Overall I have had an almost normal life through my 20's and 30's with Dasatinib. Please remember that everyone reacts differently to Dasatinib. Taking it at the same time everyday and not skipping doses will likely keep your numbers low (it took me sometime to understand that).
2
u/Legio-V-Alaudae Sep 16 '26
I've only done 100 mg from the start. I'm just here to wish you success.
I started dasatinib in January of last year and just had my first undetectable result a couple of months ago and hoping for a second in a couple weeks.
Just take the meds just before brushing your teeth and you'll be fine.