Remission for Chronic Myelogenous Leukemia
How Do I Know if I'm Having a Relapse?
It's likely to show up in a blood test, so it's important to see your doctor for regular checkups.
"We define relapse in general as 'backward movement,' and ... the patient is unlikely to have any change in the way they feel," Mauro says.
Your doctor will use the same categories he used when talking about remission to describe a relapse.
For example, he could refer to a "hematologic" relapse in your blood cell count.
Or he could tell you that you've had a "cytogenetic" relapse, which means you again have cells with the Philadelphia chromosome.
He could also say you have a "molecular" relapse, which means you have some of the BCR-ABL gene in your blood.
If you have one of these changes, 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."