AML-M2, taken Cytrabine, done low density chemotherapy, had Parkinson's disease. Can Imatinib mesylate cure?

default
Posted on Tue, 2 Oct 2012 in Blood Cancer(Leukemia)
Question: My father has been diagnosed of AML-M3 he is 72 years old, he has undergone low density chemo which is cytrabine injection twice daily for 5 days and suffering from parkinsons for last 13 years. Please advise if 'Imitinef Mercilet' can cure him
doctor
Answered by Dr. Indranil Ghosh 9 hours later
Hi,
Thanks for the query.

Sorry to hear about your father. If he really has AML-M3(acute myeloid leukamia-subtype-3) (which can be confirmed by doing FISH(fluorescence in situ hybridization) or RT-PCR (reverse-transcription polymerase chain reaction)test on blood/bone marrow), then he has a real chance of cure with available medicines like ATRA (vesanoid) or arsenic trioxide (Arsenox), either alone or in combination.

Low intensity cytarabine cannot cure him.

The drug which you are referring to as 'Imitinef Mercilet' is probably nothing but imatinib mesylate, which is a drug for chronic myeloid leukemia. It has no activity against acute myeloid leukemia.

In addition to drugs, he needs good supportive care, like antibiotics, blood products, hygiene, etc.

Hope I have answered your queries.I will be available for follow up.

Best wishes,
Above answer was peer-reviewed by : Dr. Radhika
doctor
default
Follow up: Dr. Indranil Ghosh 1 hour later
Most of the doctors we have gone to have told us clearly that this is not curable due to the age factor, as he is 72 years and we can only increase his life expectancy......do you suggest i recommend these medicines to the doctor we are currently referring to - Mr. XXXXXXX XXXXXXX - Oncologist - Medhanta Hospital - Delhi
By mistake i wrote AML - Subtype 3 but he has AML - 2..........PLEASE ADVISE.

I am attaching the report
doctor
Answered by Dr. Indranil Ghosh 3 hours later
Hello,

Thanks for the clarification.

It seems to be AML (Non-M3); However, I could not find FISH (fluorescence in situ hybridization) or RT-PCR (Reverse Transcriptase- Polymerase Chain REaction) or cytogenetics reports.

In Non-M3 AML, the drugs I mentioned do not work.

If it is AML-M2, then I feel he is receiving appropriate treatment. High-intensity treatment is mostly non-feasible in his age, with the other problems.

I have full faith on the abilities of Dr. XXXXXXX and Dr. XXXXXXX Bhargava (his associate).

Please feel free to ask if you have any other queries.

Wish you and your father good health.

Regards,




Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
default
Follow up: Dr. Indranil Ghosh 1 hour later
His last blood report shows no blast cells, what does this mean. He still feels very low and cannot move around much in the house as well.
Will all his counts come back to the normal counts he had one month back, we as family are still under shock the believe that our father is suffering from this.
doctor
Answered by Dr. Indranil Ghosh 49 minutes later
Hello,

Thanks for writing again.

Clearance of blast cells from the peripheral blood is a good sign, which shows that he had shown some response to the treatment.

But, if a bone marrow is repeated at this point, I am sure it will show blasts. His counts may improve also, albeit for a limited period. Exact chances are difficult to predict.

You as a family are doing the best for him, as are the doctors. We can only hope for the best.

I hope this answers your query.

Wish you and your father a good health.

Regards,
Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
default
Follow up: Dr. Indranil Ghosh 26 minutes later
Have you ever come across a case like this before, is it true that the low density chemo is the only way to keep him going.

How many times should the chemo be repeated? i know i am bothering you but as a daughter i am only trying to understand that do we still have no cure for this problem at his age.

Most of the Cancer patients are treated and they do good for many years but since the last blood report and the chemo given we see no improvement in his physical condition.
doctor
Answered by Dr. Indranil Ghosh 1 hour later
Hello,

Thank for writing again.

I have treated quite a few cases like this. Some do well for a short period and then again disease progresses. However, some cases do not benefit at all. If benefit is there, we can give 3-4 cycles of treatment.

Unfortunately, cure is not probably a realistic goal for your father. Please go through the following guidelines for treatment of AML issued by the European Leukemia Network..."Older patients are more likely to suffer treatment-related early death and to exhibit therapeutic resistance. Increasing age is associated with factors predictive of early death, for example, poor performance status or various comorbidities, and of treatment resistance, for example, adverse cytogenetics. Even with this low-intensity approach, mortality of 26%.

Any discussion on choice of therapy must refer to observations that 74% of older patients estimated that their chances of cure with ā€œ3+7 (standard induction for younger patients)ā€ were 50% or more; in contrast, 85% of their physicians estimated this chance to be less than 10%"

I understand your concern as a daughter and I know I am unable to show you any way of hope, but that is how it is.

I hope this answers your query.

Wish you best of luck.

Regards,

Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1515 Questions

premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,   ,  
Drug/Medication ,  

Recent questions on  Acute leukemia

doctor1 MD

Dear doctors Iā€™m super worried . I went for a physical exam and found out my wbc are a little to high than Normal at 12.13 reference range is...

doctor1 MD

Age:36, Gender: Male Good morning, I did blood tests: we use canadian units Hb 145 10^9 (normal) Wbc 7.4 10^9 (normal) Lymphocytes 1.9 10^9...

doctor1 MD

My mother has had recent bloodwork taken over the course of the past 3-4 months. The first time she had it done, the results came back with...

doctor1 MD

my name is haris i was diagnos by blood cancer acute leukemia lymphoblastic my age is 23 and my height is 183 cm and my weight is 100 kg.. my...

doctor1 MD

My mother, 92, has acute myeloid leukemia. After many transfusions, her iron levels are very high---her ferritin recently was tested at almost...

doctor1 MD

Hello,
My husband's maternal uncle has been diagnosed with AML - M2. He has been hospitalized ever since.. He's platelet count has been fluctuating...

doctor1 MD

sir i am mehtab from pakistan sir i am biotechnologist.sir my niece is patient of acute lympoblastic leukemia since eight month the bone marrow and...

Get personalised answers from verified doctor in minutes across 80+ specialties

132 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
backtotop2