What are the treatment options for someone who has Philadelphia (Ph) chromosome-negative CML?
Patients with Ph chromosome-negative CML lack evidence of the translocation, or swapping, of genetic material that produces the abnormal gene BCR-ABL. In most CML patients, it is the BCR-ABL gene that tells the body to produce abnormal white blood cells. While Ph chromosome-negative does not respond to therapies like Gleevec that target the abnormal BCR-ABL gene, there are some standard and some experimental CML treatments that might be useful. But first I’d make sure that you’ve had thorough testing to confirm that the Ph chromosome is, in fact, absent. Some patients have no evidence of the Ph chromosome upon basic cytogenetic analysis (the mapping of chromosomes that can reveal the Ph chromosome, a translocation of chromosomes 9 and 22), but may show evidence of the BCR-ABL abnormal gene in the more sensitive cytogenetic tests, FISH (flourescent in situ hybridization) or PCR (polymerase chain reaction).
