CML Testing

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. After diagnosis progress can be measured by simple blood tests. Regular tests, usually at 3-month intervals, will be needed to monitor the levels of leukemia cells in the blood or bone marrow. 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
Months after diagnosis

Complete Hematologic Response (CHR)

Months after diagnosis

Any Cytogenetic Response (CyR)

Months after diagnosis

Major Cytogenetic Response (MCyR)

  • Ph+ cells reduced to 35% or less
Months after diagnosis

Complete Cytogenetic Response (CCyR)

  • No Ph+ cells detected
Ongoing Testing

Maintain CCyR

  • Continued monitoring with quantitative polymerase 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.

Reduction in leukemia cells at each successive response level

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

This Web site is not meant to replace a discussion with your doctor, who is your most important source for information.

All individuals depicted in this Web site are models being used for illustrative purposes only. MyCMLCare, "Get the strength that comes from knowledge", CML Treatment Companion, and CML Currents are registered trademarks of Bristol-Myers Squibb Company.