It’s understandable to feel overwhelmed by a diagnosis of Philadelphia chromosome–positive chronic myeloid leukemia (Ph+ CML) in chronic phase. While thinking about treatment goals may not be the first thing that comes to mind, it is something you’ll want to discuss with your doctor as you consider different medications.

Start on a medication you can stay with

Having a CML medication that combines effectiveness with manageable side effects can make it easier to stay on treatment. That can mean better results for you. So you’ll want to ask your doctor some questions before you start on treatment. Below are some questions you may want to ask.

Setting treatment goals

While every patient is different, it’s important to work closely with your doctor to discuss treatment goals. Some common goals include:

• Reducing the number of leukemic cells in the body

• Reducing the amount of BCR::ABL protein in the body; your doctor may refer to this as a molecular response

Responding to treatment

Your doctor may discuss treatment milestones with you. Simply put, these are goals of treatment.

The milestones below show an ideal response to medication. You may want to review this information with your doctor. The illustrations can help you picture how your blood counts may come down over time with treatment. The dots represent the number of BCR::ABL1 cells in the body.

Of course, not every patient will reach every treatment milestone. As long as you and your doctor are seeing your blood counts go down or your numbers are staying stable, you are responding to the medication.

At Diagnosis: Baseline

• Initial tests likely show a high level of blood cells with the abnormal BCR::ABL1 gene

• Your doctor will use this number as a baseline—or starting point. This is typically 100%, which means 100 out of 100 cells have the BCR::ABL1 gene

Early Molecular Response (EMR) or Complete Hematologic Response (CHR)

• Blood counts for red blood cells, white blood cells, and platelets return to normal

• With EMR, BCR::ABL1 is ≤10% of all the cells in your blood. This means that 10 out of every 100 cells have the BCR::ABL1 gene

Complete Cytogenetic Response (CCyR)

• If there are no Ph+ cells detected in the bone marrow, your doctor may say you have a CCyR

• With CCyR, BCR::ABL1 in the blood is ≤1%, meaning that 1 out of every 100 cells has the BCR::ABL1 gene

Major Molecular Response (MMR)

• With MMR, BCR::ABL1 in the blood is ≤0.1%. In this case, 1 out of every 1,000 cells has the BCR::ABL1 gene

Deep Complete Molecular Response (DMR): MR4.0 or MR4.5

• With DMR, BCR::ABL1 in the blood is ≤0.01% (MR4.0) or ≤0.0032% (MR4.5). 
  This means that, at most, 1 out of every 10,000 cells has the BCR::ABL1 gene

Complete Molecular Response (CMR)

• With CMR, BCR::ABL1 in the blood is undetectable

How is response measured?

Monitoring your blood is an important part of managing Ph+ CML in chronic phase. Your doctor will prescribe a range of blood tests to see if you are responding to treatment. Learn more

What if you’re not reaching your milestones?

If you’re not responding to your medication, it’s important to be your own advocate and talk with your doctor. It may be time to have a conversation about changing treatment. You can learn more about SCEMBLIX as a treatment option after you’ve already been on another medication here.

Next: Monitoring Ph+CML in Chronic Phase>