Gleevec Prescription Medication information for CML

Your doctor will do tests regularly to see how well your treatment with Gleevec is working. Any of these tests may be used to track your response to treatment:

Hematologic testing—A simple blood test to see whether your levels of white blood cells, red blood cells, and platelets have returned to normal. If they have, it is called a complete hematologic response. Your doctor will expect to see a complete hematologic response within about 3 months of starting Gleevec. This response means that you are responding to Gleevec. However, even if your blood counts return to normal, you may still have leukemic white blood cells containing the Ph chromosome in your body
Cytogenetic testing—A test done on bone marrow cells that scans a small number of cells (about 20 to 30) to see if they still contain the Ph chromosome. Cytogenetic testing lets your doctor track your disease even after your blood counts have returned to normal. When cytogenetic tests show that the number of cells with the Ph chromosome is decreasing, this is called a cytogenetic response. Generally, if your Ph+ CML responds to Gleevec, you will see some decrease in Ph+ cells as as soon as 6 months after starting treatment with Gleevec
FISH (fluorescence in situ hybridization)—Another test done on either blood or bone marrow cells that looks for abnormal cells that contain the bcr-abl gene, which is located on the Ph chromosome. This test can find 1 abnormal cell out of 200 to 500 normal cells
PCR (reverse transcriptase-polymerase chain reaction)—This is the most sensitive test for monitoring CML. It counts the number of cells containing the bcr-abl gene. It can be done on either blood or bone marrow cells and can detect the presence of the bcr-abl gene in up to one in one million cells. Because PCR testing detects a gene, it is also referred to as molecular monitoring. If this test shows a significant reduction in the number of bcr-abl genes, it is called a molecular response, which means that Gleevec is doing its job. Gleevec is not a cure. Even if you have a complete molecular response, which means the PCR test does not detect the presence of any bcr-abl genes, there still might be leukemia cells left in your body. So even though your response to Gleevec is extremely good, it remains important that you keep taking your Gleevec as your doctor has prescribed

Talk to your doctor about the goal numbers you are looking for and how soon you should expect to see a response.
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What does it mean if your test results are not meeting the treatment goals your doctor and you discussed?
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If you are taking Gleevec exactly as prescribed every day and it is not achieving your treatment goals, your doctor may suggest a higher dose of Gleevec. If the Ph+ CML does not respond to Gleevec or stops responding, your Ph+ CML may have developed a resistance to Gleevec. However, resistance is rare in people who start Gleevec in the chronic phase of the disease. If it does occur, your doctor may suggest a change in therapy.

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