Ph+ CML response goals—CHR, CCyR, and MMR

Ph+ CML typically progresses through three disease
phases—chronic, accelerated, and blast crisis—characterized by worsening clinical features and laboratory findings (See Table 1).

Table 1:

Please click on the image to enlarge it

A hematological response (HR) includes reducing white blood counts to normal values, eliminating immature myeloid cells from the peripheral blood, and eradicating the signs and symptoms of disease (See Table 2 below).

Cytogenetic response is based on analysis of bone-marrow aspirates and the reduction or elimination of Ph+ cells. A complete cytogenetic response (CCyR) is defined by the absence of detectable Ph+ cells in bone marrow, and a partial cytogenetic response (PCyR) is defined as the presence of 1% to 35% Ph+ cells by standard cytogenetic techniques. Together, complete and partial responses constitute a major cytogenetic response (MCyR).¹

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 the International Randomized study of Interferon and STI571 (IRIS) trial.²

Table 2: Response measurement criteria³

Please click on the image to enlarge it

Next: ELN Recommendations

Note: Before prescribing, please read full European Summary of Product Characteristics.