title: Molecular monitoring 101: helping your patients with chronic myeloid leukemia to understand the meaning of molecular response.
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.
authors.affiliation: Department of Leukemia, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Elias J
authors.initials: EJ
authors.lastname: Jabbour
authors.forename: Alfonso
authors.initials: A
authors.lastname: Quintás-Cardama
mesh_terms: D003582:Cytogenetics / Q000379:methods; D004252:DNA Mutational Analysis; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis* / Q000235:genetics* / Q000628:therapy; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D010817:Physician-Patient Relations; D012333:RNA, Messenger / Q000378:metabolism; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D015203:Reproducibility of Results
chemical_list: D012333:RNA, Messenger; D016044:Fusion Proteins, bcr-abl