Understanding Remission

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Remission During Chronic Phase CML: Watching for Relapse

WebMD Feature By

Reviewed By Brunilda Nazario, MD

Learning that you have a cancer like leukemia can be devastating. So when Gail

J. Roboz, MD, has to tell patients they have chronic myelogenous leukemia (CML),

she tries to emphasize the positive.

" The bad news is you do have a type of leukemia, but the good news is if you

have to pick a type of leukemia, you picked a good one to have, " the associate

professor of Medicine and director of the Leukemia Program at Weill Cornell

Medical Center tells her patients. " The new treatments for CML have completely

revolutionized care. Many patients can be treated with pills, and can have an

excellent to nearly perfect quality of life. "

The medication used to treat CML is very good at keeping the disease under

control. But in order for you to have the best possible response, you must play

an active part in your own care. That means following your CML treatment so that

you have a complete response and keeping up with your tests to prevent a

relapse.

Living with CML

Most people are diagnosed with CML when they are still in the chronic phase –

the earliest stage of the disease. In the chronic phase, the number of abnormal

white blood cells in your body is still low and the disease is easiest to treat.

Your doctor will likely start your CML treatment with a drug called a tyrosine

kinase inhibitor (TKI). TKI drugs target tyrosine kinase, the abnormal protein

that causes your body to produce abnormal white blood cells. Many doctors start

their patients with the drug imatinib (Gleevec).

With drug treatment, your doctor will try to normalize your blood count and

eliminate the abnormal white blood cells. The treatment will also help prevent

your CML from progressing to the more serious accelerated and blastic phases. In

the later phases, CML becomes harder to treat.

TKI drugs work quickly -- and effectively. " Our hope is that blood counts will

go to normal within six weeks to three months after starting treatment, " Roboz

says. About 90% of patients have a complete response within five years of

starting Gleevec treatment.

Keeping on Top of Your CML

CML isn't like other conditions -- you can't just take a few pills and make it

go away. Treating CML is a life-long effort. You have to keep taking Gleevec or

another drug like it to keep your blood cells in the normal range.

Throughout your treatment, your doctor will monitor your CML with these blood

and bone marrow tests:

a.. Blood cell counts to check the levels of white blood cells, red blood

cells, and platelets.

b.. Cytogenetic tests to look for the abnormal CML chromosome (the

Philadelphia chromosome) in a bone marrow sample.

c.. Fluorescence in situ hybridization (FISH) and polymerase chain reaction

(PCR) tests to look for the abnormal bcr-abl gene in your cells.

d..

e.. http://tinyurl.com/4rfpe92

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f.. The Program That Helps Pay for Medications

Call 1-866-972-8313 to enroll.

g.. http://tinyurl.com/4tjz7zy

h..

If you are being treated with GLEEVEC® (imatinib mesylate) tablets or TASIGNA®

(nilotinib) 150-mg or 200-mg capsules for Philadelphia chromosome-positive (Ph+)

chronic myelogenous (or myeloid) leukemia (CML), you may now qualify for the My

CML Circle Co-Pay Card.

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FYI,

Lottie Duthu