Contents
Navigating CML: Your Roadmap to Effective Management and Monitoring
Published: Dec 15, 2023
Managing Chronic Myeloid Leukemia (CML) is a long-term journey that requires careful monitoring and adherence to treatment guidelines. Understanding these guidelines can help you navigate your CML journey more effectively.
Initial Diagnosis and Staging
When CML is first diagnosed, it's crucial to determine the disease phase: chronic, accelerated, or blast crisis. This involves blood tests, bone marrow biopsy, and genetic tests for the BCR-ABL1 gene. Your doctor will also calculate a prognostic score, such as the Sokal or ELTS score, to help guide treatment decisions.
Treatment Initiation and Monitoring
Most patients start with a tyrosine kinase inhibitor (TKI) like imatinib, nilotinib, or dasatinib. Regular monitoring is crucial to ensure the treatment is working. This includes blood counts every 2 weeks until response is achieved, then every 3 months. BCR-ABL1 testing (PCR test) is typically done every 3 months to measure the level of leukemia cells.
Response Milestones and Treatment Adjustments
Doctors look for specific response milestones at 3, 6, and 12 months of treatment. If these milestones aren't met, it may be time to switch to a different TKI or consider other treatment options. The goal is to achieve a major molecular response (MMR), where the BCR-ABL1 level is very low or undetectable.
Frequently Asked Questions
Initially every 2 weeks, then every 3 months once stable.
Blood counts and PCR tests for BCR-ABL1 levels every 3 months.
Some patients achieve treatment-free remission, but only under close medical supervision.
Your doctor may switch you to a different TKI or explore other treatment options.
Your Partner in Care
Following these guidelines closely, in partnership with your healthcare team, gives you the best chance for successful CML management.
References
- Baccarani M, Deininger MW, Rosti G, et al. European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood 2013; 122:872.
- National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Chronic Myeloid Leukemia. Version 3.2020.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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