Molecular monitoring 101: helping your patients with chronic myeloid leukemia to understand the meaning of molecular response

Leuk Lymphoma. 2012 Aug;53(8):1452-60. doi: 10.3109/10428194.2012.659734. Epub 2012 Mar 1.

Abstract

For patients with chronic myeloid leukemia (CML), measurement of molecular response (i.e. the level of BCR-ABL1 transcripts) is firmly established as a key element of disease monitoring. Assessment of BCR-ABL1 levels may help to identify early signs of resistance to treatment and enable a timely switch to alternative therapies. Hence, regular and accurate monitoring of BCR-ABL1 transcripts helps to maximize the chance of successful outcomes in CML. Because the incidence of CML is relatively low, many community oncologists encounter only a limited number of cases; measuring and interpreting BCR-ABL1 measurements in a clinically relevant fashion may be challenging. The team at our institution often encounters questions regarding real-time quantitative polymerase chain reaction assessments of BCR-ABL1 levels, International Scale standardization, the implications of achieving or losing molecular responses and mutation monitoring. The aim of this article is to provide practical advice for effective long-term monitoring of patients with CML by addressing frequently asked questions and common case scenarios using guideline- and evidence-based approaches.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cytogenetics / methods
  • DNA Mutational Analysis
  • Female
  • Fusion Proteins, bcr-abl / genetics*
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Medical Oncology / methods
  • Middle Aged
  • Physician-Patient Relations
  • RNA, Messenger / metabolism
  • Real-Time Polymerase Chain Reaction / methods
  • Reproducibility of Results

Substances

  • RNA, Messenger
  • Fusion Proteins, bcr-abl