How Should Patients With Chronic Myeloid Leukemia Be Monitored?
Slide 23. How then should a patient responding to treatment be monitored? Slide 24. It’s important to stress that I don’t know the answer. All I can do is make some suggestions, which are certainly subject to discussion and criticism. In a responding patient, a patient whose leukocyte count and platelet count are now in the normal range, it would be reasonable to look at the cytogenetics at 3-month intervals, although I’m quite sure some of our patients will object to that. Once the patient is Philadelphia negative for a minimum period of perhaps 6 months, I think it would be reasonable to omit marrow examinations, and the combination of RT-PCR on blood and FISH on blood may be acceptable. The problem with this is that you may miss evidence of clonal evolution in the Philadelphia-positive population, if there is one, but there may also be evidence of clonal evolution in the Philadelphia-negative population, which is a very interesting observation. I think you can use the argument that
