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Hello,
I am looking for advice on treatment of a patient for STRN with history of CML (Chronic myelocytic leukemia) diagnosed about 4 year ago. He is currently being treated with Gleevac (imatinib mesylate). Are there any contraindications for CML and this medication for HBOT?

Thanks, Shelly Hardman, APRN.
Dec 15, 2022 by Shelly Hardman, APRN
4 replies
Mike White
MD, UHM, MMM, CWS
Shelly,

This is a great question with not a really clear answer. I could find no information on Gleevac and HBO doing a quick literature search. I did find a response John Feldmeier made when asked about chemo and HBO together in 2016 (https://www.uhms.org/resources/medfaqs-frequently-asked-questions-faq/60-medical-patient-care.html). At that time Dr. Feldmeier recommended not using certain chemo agents (Bleomycin, Avastin) but also questions using some of the biologics and HBO together. I will continue to search and see if I can find a better answer.
Dec 16, 2022
I thought I had replied but I don't see it so disregard if this is double.
Thank you for your help. Do you feel CML is a contraindication to HBO? This particular case has been treated, its not a new dx of CML.
Dec 19, 2022
Elaine Horibe Song
MD, PhD, MBA
Hi Shelly,

Scott Robinson MD shared some additional thoughts: While he doesn't believe that CML (or any malignancy) is a contraindication to HBOT, he is unsure about whether biologics could be. He suggests weighing risks and benefits of HBOT vs. the need to continuously use biologics. That is, if biologics could be paused, then patient could potentially undergo HBOT while disease progression is closely monitored. Dr Robinson had a case in which the patient had STRN to the skin over the scapula, as it had been irradiated due to bone metastasis. Oncologist agreed to pause biologics and closely monitor progression of the disease while patient was on HBOT (in that case, patient had evidence of metastasis in the lungs, which was monitored with CT scan). As the disease didn't progress, they completed HBOT, then the patient had a flap rotated for definitive coverage. 

Also, please refer to this section on treating patients with active cancer: https://woundreference.com/app/topic?id=an-introduction-to-hyperbaric-oxygen-therapy_x#considerations-for-active-cancer-and-hbot
Dec 23, 2022
Thank you
Dec 23, 2022
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