BCR-ABL Gene [B.C.R.-a-bull jeen] — the abnormal gene made by the Philadelphia chromosome. It makes the Bcr-Abl protein. The Bcr-Abl protein causes the bone marrow to produce too many white blood cells. These white blood cells are also often damaged.
Bone Marrow — soft, sponge-like tissue that is found inside the hard outer covering of most bones; the bone marrow makes red blood cells, white blood cells, and platelets.
Chromosome [crow-mow-sow-m] — a part of a cell that carries genetic information or genes. A chromosome is made of DNA— the information that determines the color of our eyes and hair, and many other features. Chromosomes are found in the cell nucleus or center. Normal human cells have 46 chromosomes, made up of 23 pairs.
Chronic Myeloid Leukemia (CML) [cron-ic my-a-loid loo-key-me-a] — a type of cancer of the bone marrow and white blood cells that generally develops slowly. In CML the bone marrow makes too many damaged white blood cells.
Complete Blood Count (CBC) — when the numbers of different kinds of blood cells in a blood sample are counted using a special machine.
Complete Cytogenetic [site-oh-jen-e-tic] Response (CCyR) — see Cytogenetic Response.
Complete Hematologic [he-mat-oh-loj-ic] Response (CHR) — see Hematologic Response.
Cytogenetic [site-oh-jen-e-tic] Response (CyR) — in Ph+ CML, this means a decrease or fall in the number of cells containing the Philadelphia chromosome in the bone marrow following treatment. A complete cytogenetic response means that no cells containing the Philadelphia chromosome can be detected in the bone marrow. This does not mean, however, that Ph+ CML is cured.
Cytogenetic [site-oh-jen-e-tic] Test — a test of your bone marrow that counts the number of cells in a bone marrow sample that contain the Philadelphia chromosome. Cytogenetic tests help your doctor learn if you are responding to Ph+ CML treatment.
Fluorescence in situ hybridization (FISH) [Floor-es-scence in sit-u high-brid-eyes-a-shun] — a kind of cytogenetic test that can be used to find out if the abnormal BCR-ABL gene that causes Ph+ CML is present in the cells in your bone marrow.
Gene [jeen] — a part of a chromosome that carries information that is needed to make a single protein. A gene is made of DNA.
Hematologic [he-mat-oh-loj-ic] Response — when blood tests show the numbers of white blood cells, red bloods, and platelets have returned to normal. This does not mean, however, that Ph+ CML is cured.
Hematologic [he-mat-oh-loj-ic] Test — when a sample of blood is analyzed to see if a patient has abnormal numbers of blood cells or to monitor how a patient is responding to treatment.
Molecular [moll-ec-you-lah] Test — in Ph+ CML, this means counting how many cells containing the abnormal protein there are in a sample of blood or bone marrow to see if there is a response to treatment.
Ph+ CML — a shortened version of Philadelphia chromosome-positive chronic myeloid leukemia.
Philadelphia Chromosome [fill-a-dell-fee-a crow-mow-sow-m] — an abnormal or damaged chromosome that is found in the white blood cells of nearly all patients (95%-100%) with chronic myeloid leukemia (CML). It replaces the normal chromosome.
Platelet [plate-let] — a kind of blood cell that helps to prevent bleeding by causing the blood to clot.
Q-RT-PCR (quantitative reverse transcription-polymerase chain reaction) — a laboratory test that is sensitive enough to detect one cell containing the abnormal Bcr-Abl protein in up to 1 million normal cells in a patient with Ph+ CML.
Red Blood Cell — a kind of blood cell that contains hemoglobin; red blood cells are responsible for carrying oxygen around the body.
White Blood Cell — a blood cell that appears white because it does not contain any hemoglobin; white blood cells are made by the bone marrow and are important to help the body fight infection.
Monitoring Your Ph+ CML
QT prolongation causes an irregular heartbeat, which may lead to sudden death.
Your doctor should check your heart with a test called an electrocardiogram (ECG):
TASIGNA® (nilotinib) Indications
TASIGNA is a prescription medicine used to treat adults with newly diagnosed Philadelphia chromosome–positive chronic myeloid leukemia (Ph+ CML) in chronic phase. The efficacy of TASIGNA is based on major molecular response and cytogenetic response rates. The study is on-going and more data will be needed to determine long-term outcomes.
TASIGNA is also used to treat chronic phase or accelerated phase Philadelphia chromosome–positive chronic myeloid leukemia (Ph+ CML) in adults who are no longer benefiting from previous other treatments, including imatinib (GLEEVEC), or have taken other treatments, including imatinib (GLEEVEC) but cannot tolerate them. The efficacy of TASIGNA is based on hematologic response and cytogenetic response rates.
IMPORTANT SAFETY INFORMATION ABOUT TASIGNA® (nilotinib)
What is the most important information to know about prescription TASIGNA?
TASIGNA can cause a possible life-threatening heart problem called QT prolongation.
QT prolongation causes an irregular heartbeat, which may lead to sudden death.
Your doctor should check your heart with a test called an electrocardiogram (ECG):
You may lower your chances for having QT prolongation with TASIGNA if you:
Who should not take TASIGNA?
Do not take if you have:
Taking TASIGNA:
Before taking TASIGNA
Talk to your doctor or pharmacist about all other medication(s) you may be taking, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements, since they may affect how TASIGNA works and increase your chance of serious and life-threatening side effects.
Tell your doctor if:
Also tell your doctor if you are pregnant, breast-feeding, or lactose-intolerant. The TASIGNA capsules contain lactose. Most patients who have mild or moderate lactose intolerance can take TASIGNA.
Serious side effects
TASIGNA may cause serious side effects including:
Your doctor may do blood tests to check you for TLS
Call your doctor immediately if you experience any of these symptoms. Your doctor may change your dose. Your doctor may have you stop TASIGNA for some time or lower your dose if you have side effects with it.
Common side effects
Most patients experience side effects at some time. Some common side effects you may experience include:
Be sure to tell your doctor or pharmacist if you have any side effects during treatment with TASIGNA. You are encouraged to report side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
It is not known if TASIGNA is safe or effective in children.
Tell your doctor if you are pregnant or planning to become pregnant. TASIGNA may harm your unborn baby. If you are able to become pregnant, you should use effective birth control during treatment with TASIGNA. Talk to your doctor about the best birth control methods to prevent pregnancy while you are taking TASIGNA.
Tell your doctor if you are breast-feeding or plan to breast-feed. It is not known if TASIGNA passes into your breast milk. You and your doctor should decide if you will take TASIGNA or breast-feed. You should not do both.
If you take too much TASIGNA, call your doctor or poison control center right away.
Your doctor will check your heart, do regular blood tests, and take bone marrow samples during treatment with TASIGNA. These are done to check for side effects with TASIGNA and to see how well TASIGNA is working for you. Your doctor should check your blood to monitor the amount of blood cells (white blood cells, red blood cells, and platelets) during treatment. These should be checked every 2 weeks for the first 2 months and then monthly thereafter, or as considered necessary by your doctor.
Please see the full prescribing information including the Boxed WARNING, and the TASIGNA Medication Guide.