People with chronic myeloid leukemia (CML) need to be tested for the rest of their lives because of the nature of the disease. Tests help you and your doctor see how you're doing.
Since everyone is different, your doctor will order regular tests of your blood and bone marrow to see how you're responding to your therapy. Regular CML testing is necessary even if you are getting good results.
Why so many tests?
Each type of CML test has a different degree of sensitivity. At first, progress can be measured by simple blood tests. After that, if your CML is being managed successfully, and your test results improve, more sensitive tests will be needed to detect fewer and fewer leukemia cells. Your doctor will be able to tell from those tests how your CML is responding to treatment. Talk to your doctor about what CML tests you will be given, when you'll be tested and how often, and what your test results mean.
What CML tests can tell you and your doctor
- The current phase of your disease
- The percentage of cells in your blood and bone marrow that are Philadelphia chromosome-positive (Ph+)
- How you may respond to treatment over time
- If your CML is no longer responding to your current medication
CML testing goes hand in hand with treatment
If you have chronic phase CML, what's important is to keep your CML from progressing—getting worse. With that in mind, you and your oncologist will have 2 basic goals:
- To get the levels of all the different types of blood cells back to normal
- To reduce or eliminate the cells carrying the Philadelphia chromosome
| Test Timing |
Test Goals |
3
Months after diagnosis |
Complete Hematologic Response (CHR)
|
6
Months after diagnosis |
Any Cytogenetic Response (CyR)
|
12
Months after diagnosis |
Major Cytogenetic Response (MCyR)
- Ph+ cells reduced to 35% or less
|
18
Months after diagnosis |
Complete Cytogenetic Response (CCyR)
|
| Ongoing Testing |
Maintain CCyR
- Continued monitoring with quantitative ploymerase chain reaction (QPCR) testing every 3 to 6 months
- Bone marrow testing may be performed by your doctor in some instances
|
Turn your test results into talking points
The goals and milestones you can find on this site—and elsewhere—are simply general guidelines for a doctor to consider when treating people with chronic-phase CML. You and your doctor will discuss your particular goals and when you should achieve these goals.
What's important is the continuing conversation between you and your oncologist that will allow you to review your own personal testing goals and timelines and see how your results are matching up. You'll want to discuss in detail how the general goals apply to you and ensure over time that you are achieving your treatment goals.
Bear in mind—as your doctor will—that there are a lot of factors that can affect the way you respond to treatment. The more you understand, the more engaged you'll be, and the more you'll be an active partner in your treatment.
Find out more about the 3 types of CML tests
When your treatment is working, the number of leukemia cells decrease, so simple blood tests will no longer detect them. In the image below, each type of test is more sensitive than the one before it, detecting levels of cancer that can't be detected by the previous type. The most sensitive test can detect 1 leukemia cell among
1 million normal cells.
Adapted from Lowenberg B, et al. Minimal residual disease in
chronic myeloid leukemia. N Engl J Med. 2003: 1399-1401.
- Hematologic Testing and CHR
Blood counts back to normal, no leukemia blast cells, no signs or symptoms of CML- Cytogenetic Testing and CCyR
Philadelphia positive (Ph+) cells undetectable- Molecular Testing, MMR, and CMR
Philadelphia positive (Ph+) cells undetectable by measuring BCR-ABL signals