Remission During Chronic-Phase CML
How Do I Know if I’m Having a Relapse? continued...
“We define relapse in general as ‘backward movement,’ and … the patient is unlikely to have any change in the way they feel,” Mauro says. “That’s an advantage. We can intervene when there are only subtle changes at a deeper level.”
A relapse is identified through the same categories as your remission.
You could have a:
- Hematologic relapse found in your blood cell count
- Cytogenetic relapse where cells with the Philadelphia chromosome are once again detected in your blood or bone marrow
- Molecular relapse where amounts of the BCR-ABL gene are found in your blood
If one of these changes is found, your doctor will repeat the test to rule out error.
“It’s very important to not jump to a conclusion based on a single lab reading. That’s a mistake patients make because they are worried,” Roboz says. “They see their white blood cell count go up at one visit, but it might just be they caught a cold from their kids and their white blood cell count is responding normally."
If changes are confirmed, doctors may do a bone marrow biopsy to look for changes in the chromosomes so they can figure out what treatment might work better for you.
“Some patients respond quickly to a change in medication and do well, and there are others who need to try one or two times with different medications,” Roboz says. “But it is not true that a relapse is definitely devastating news. There are plenty of patients who will be switched to a different CML medication and do extremely well.”