At diagnosis | Chromosome banding analysis (CBA) of marrow cell metaphases FISH in case of Ph negativity to identify variant, cryptic translocations Qualitative PCR (identification of transcript type) |
During treatment | Quantitative real-time PCR (RQ-PCR) for the determination of BCR-ABL1 transcripts level, to be performed every three months until an MMR (BCR-ABL1 ≤0.1 percent, or MR3.0) has been achieved, then every three to six months and/or CBA of marrow cell metaphases (at least 20 banded metaphases), to be performed at 3, 6, and 12 months until a CCyR has been achieved, then every 12 months. Once a CCyR is achieved, FISH on blood cells can be done. If adequate molecular monitoring can be ensured, cytogenetics can be spared. |
Failure, progression | RQ-PCR, mutational analysis, and CBA of marrow cell metaphases. Immunophenotyping in BP. |
Warning | Molecular and cytogenetic tests to be performed more frequently. CBA of marrow cell metaphases recommended in case of myelodysplasia or CCA/Ph– with chromosome 7 involvement. |
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