CML After Age 65: What are th... Video Transcript

Participants

, Lois Reek , Tom Reek , David Savage MD, Gabrielle Morris MD

Summary

Some treatment options are not available for patients with chronic myeloid leukemia when they are over 65 years old. But most can still look forward to a range of effective medical therapies and a good quality of life. Listen to one man's success story.

Webcast Transcript

TOM REEK: I was playing out at a picnic, playing basketball with guys 30 years younger than me, hot as a pistol.

DAVID SAVAGE, MD: Chronologically, he was over the age of 65. However, biologically, very, very healthy and young.

TOM REEK: Once I stopped playing and I sat down, it seemed like I had trouble breathing. Not playing, when I stopped. And I was like perspiring, very heavy and it seemed like I could hear my heart.

ANNOUNCER: Tom Reek wasn't used to feeling the way most people would feel if they played a game of basketball with men half their age. His fatigue was a symptom of a serious disease. Chronic Myeloid Leukemia, or CML.

TOM REEK: I went to the library and read everything I could on leukemia, especially CML leukemia. And it scared me. It definitely scared me.

LOIS REEK: And he was not just concerned about himself, with his life expectancy, but he was concerned about me, about how I would get along without him after he was gone, because he surely thought he was going to die within a short time.

DAVID SAVAGE, MD: Suddenly to be told that he had a cancer of the bone marrow was a great shock to him. However, he is a very ebullient and enthusiastic human. And I think he bounced back from that news very quickly and was, from the beginning almost, extremely enthusiastic about whatever therapies there might be to help him.

ANNOUNCER: The first thing Tom learned about treatment for CML was that he was right on the cusp of eligibility for what doctors say is the only proven cure, a bone marrow transplant.

DAVID SAVAGE, MD: Mr. Reek was about 65 at the time of diagnosis. 65-years-of-age would be the usual cutoff for performing an allogenic stem cell transplant, which is the only curative therapy for CML.

ANNOUNCER: Even without a transplant, good treatment options were available. Tom started on a common chemotherapy drug called hydroxyurea.

DAVID SAVAGE, MD: His blood counts normalized within a few days or weeks at the most. His symptoms, his fatigue and loss of appetite, all of those problems did seem to resolve as well as the white count came down.

ANNOUNCER: But Dr. Savage and his patient sought more aggressive therapy.

DAVID SAVAGE, MD: Mr. Reek recognized that hydroxyurea was controlling his disease, but wasn't going to have any real impact on his survival.

TOM REEK: It wasn't the cure all. I knew that. It would keep me in the ball game for a while.

ANNOUNCER: So Tom started on interferon, another widely prescribed drug for CML. Unlike hydroxyurea, interferon often brings about a measurable reduction in blood cells with the abnormal chromosome -- called the Philadelphia chromosome -- that's responsible for the cancer. Unfortunately, there wasn't much benefit.

DAVID SAVAGE, MD: He was on interferon for a period of about eight or nine months. As we see in maybe 30-40% of patients, though he had no major toxicity from it, as I recall, his blood counts were never really very well controlled. In fact, he continued on small doses of hydroxyurea to keep the white count in the normal range. In addition, we never saw a cytogenetic or chromosomal response.

ANNOUNCER: By late 1999 and early 2000, a new drug was drawing much attention, based on promising clinical trials.

DAVID SAVAGE, MD: It was around that time that Gleevec became available. There had already been major reports on Gleevec in the medical literature, as well as in the newspapers.

TOM REEK: I was watching Barbara Walters one night. I was sitting up in bed and this doctor came on.