What are the early signs of relapse?
KH: Relapse may be reflected by loss of complete hematological response and evident by elevated white blood cell (WBC) counts, a rise in platelet levels above the normal range or, in some cases, by basophilia. Routine blood tests, including a CBC and differential, should be done on a regular basis to monitor ones blood counts. An enlarged spleen may indicate an elevated WBC. Another indicator of relapse is reflected by an increase in the number of cells expressing the Philadelphia Chromosome, often referred to as loss of cytogenetic response. Cytogenetics are analyzed by bone marrow biopsy or FISH analysis. Finally, a significant rise (a three-fold increase or more ) in Bcr-Abl transcripts may indicate cytogenetic relapse. Bcr-Abl levels are monitored through a PCR test.
