In chronic myeloid leukemia (CML), the term "relapse" may sometimes be used to mean a loss of response to treatment. A patient is often said to have a CML relapse when there's an increase in the number of leukemic blast cells after a particular goal or milestone has been reached. For example, tests may show you're falling short of a complete hematologic or cytogenetic response you had reached before. In particular, an oncologist may refer to a relapse if tests show that the disease is returning after a complete molecular response—or remission—has been reached.
Your oncologist will pay close attention to your test numbers, watching for any trend toward missing your treatment goals. That's why regular testing is so important, even when you've been doing well on your treatment.
Dealing with a loss of response
Your doctor will immediately look for the cause—for example, whether you may have become resistant to your treatment. No matter what the reasons for losing response, you and your doctor will have options that are important for you to discuss and evaluate together.
Remember that unlike some other kinds of cancer, CML is a chronic form of leukemia that generally isn't cured, no matter how low your numbers go. With that in mind, a relapse or any loss of response is something you and your doctor will want to take very seriously and deal with right away.
Is your treatment not working as well as it did?
There are different reasons why treatment may not be working for some. Here are some possibilities to talk over with your doctor.
- Is there a possibility that your body is building up a resistance to the medication you're currently taking? Sometimes cells in your body can change or mutate in a way that makes your treatment less effective.
- Could there be interactions between various drugs you're taking?
- Are you taking your medications exactly as your doctor prescribed?
Your oncologist may order laboratory tests to determine if you've developed resistance. If you have, there are still treatment options for you.