CML Alliance | Monitoring Molecular Response In CML Patients: Detecting The Ph Chromosome

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Monitoring Molecular Response

The Ph chromosome can be detected by standard cytogenetic techniques in the vast majority of patients.¹ In CML patients who are cytogenetically Ph-chromosome–negative (Ph-), molecular techniques such as fluorescence in situ hybridization (FISH) or reverse transcriptase polymerase chain reaction (RT-PCR) may be useful in detecting Bcr-Abl.² In addition, the use of these special techniques may have implications in disease staging or assessing residual disease.³

Although the prognostic role of these techniques continues to be clarified, there is substantial evidence that major reductions in the level of Bcr-Abl transcripts correlate with progression-free survival in patients with CML who achieve a complete cytogenetic response (CCR).⁴

Major molecular response (MMR) has been defined as at least a 3 log (1,000-fold) reduction below a standardized baseline derived from a median ratio of Bcr-Abl to Bcr obtained from 30 untreated patients with chronic-phase CML who participated in IRIS.

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References

Osarogiagbon UR, McGlave PB. Chronic myelogenous leukemia. Curr Opin Hematol. 1999;6:241-246.
Goldman JM, Melo JV. Chronic myeloid leukemia–advances in biology and new approaches to treatment. N Engl J Med. 2003;349:1451-1464.
Sawyers CL. Chronic myeloid leukemia. N Engl J Med. 1999;340:1330-1340.
Hughes TP, Kaeda J, Branford S, et al. Frequency of major molecular responses to imatinib or interferon alfa plus cytarabine in newly diagnosed chronic myeloid leukemia. N Engl J Med. 2003;349:1423-1432.

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