Rachel K:

Hi.  My name is Rachel Klein.  I am from Florida and my question is: I have had CML for 14 years.  (I am now on Bosulif® and have been on SPRYCEL® and Tasigna®).  I feel like I am having loss of memory.  I am turning 60 years old and noticed not that just where is my keys or phone.  It’s more than that.  For ex: I can be having a conversation and forgetting certain words as I am trying to explain a scenario to my girlfriend, and I’ll have to google a word to indicate what I’m trying to explain.  I’ll be driving in a familiar scenario or setting and forget where I am, and I’ll have to keep driving and realize where I am.  So, if you could answer this question, that would be great.  Thank you.

Ehab Atallah, MD:

Thank you, Rachel, for asking the question.  I want to thank LLS for this opportunity to help patients.  My name is Ehab Atallah.  I am a leukemia physician at the Medical College of Wisconsin.  So, a few things, Rachel.  As far as we know that the tyrosine kinase inhibitors, which include all the drugs you have been on, do not affect memory.  Having said that, it’s really hard to figure that out. We really need large databases to figure that out with follow-up for 10 or 15 years.  As of right now, we don’t think that the tyrosine kinase inhibitors do that.  We are doing some more research to try to figure that out by collecting data from large group of patients, but until we complete that it will be hard to say.  A few things for you is a) you definitely need to talk to your primary care physician about that because you definitely do need a workup. Anyone with memory loss would need a workup to make sure there’s nothing else that’s missing or can be done.

The second question kind of relates a little bit more to your CML.  You’ve been on treatment for a really long time.  There are patients who have been on treatment for a long time and are having a great response that a discontinuation of the drug or reduction of the dose could be considered.  There are very specific criteria for that, and I would encourage you to talk with your oncologist to see if you fit those criteria or not.  So that would be another important point.

So, to summarize, current data, we don’t think that bosutinib or any of them affect memory.  You definitely should see your primary care physician to get this worked up and discuss with your oncologist your level of response, where you are, and would you be a candidate to consider a dose reduction or discontinuation after you talk with your oncologist. Again, thank you very much.