Dr. Erba on the Diagnosis and Testing of Patients with CML

Harry Erba, MD, PhD, Professor of Medicine, Director, Hematologic Malignancy Program, University of Alabama at Birmingham, comments on the diagnosis and testing of a patient with chronic myeloid leukemia (CML).

At the time of diagnosis with CML, Erba says, it is crucial for a physician to obtain metaphase chromosomes, fluorescence in situ hybridization (FISH) analysis, and polymerase chain reaction (PCR) analysis. These tests will tell a lot about the disease and help to avoid treatment mistakes later on. Though the chance of a false negative test is low, initial tests still help to follow the patient's status, Erba says.

NCCN Guidelines recommend that every three months peripheral blood be sampled for PCR analysis. The most important part of this analysis is that physicians send these samples to laboratories which employ the International Scale. Erba views partial cytogenetic response by 12 months and complete cytogenetic response by 18 months as the most reliable and important checkpoints to achieve progression-free survival. Major molecular response is a good measure, Erba says, but does not tell much about the disease.