HCDP Manchester

CML (follow up)

PATHWAY OPTIONS
There are a number of choices. Please ensure you select the correct pathway for your sample. Please give as much clinical detail as possible for all samples.

Pathway 6A: CML monitoring of known disease (blood)

Use for known CML requiring standard blood monitoring of BCR::ABL1.
The following tests will be performed:

  • Molecular (RNA) monitor BCR::ABL1

Pathway 6B: CML possible progression (marrow)

Use for CML where disease progression is suspected. The stored DNA sample can be processed for myeloid panel if progression is demonstrated.
The following tests will be performed:

  • Morphology marrow: URGENT
  • Flow cytometry (exclude acute leukaemia)
  • Bone marrow trephine
  • Cytogenetics/FISH (CML progression) marrow
  • Molecular BCR/ABL1 & TKD
  • Molecular Myeloid gene panel (DNA)

Pathway 6C: CML suspected treatment resistance (blood)

Use for CML with suspected treatment resistance (blood).
The following tests will be performed:

  • Molecular BCR/ABL1 & TKD
  • Molecular (DNA) hold

Pathway 6D: CML suspected treatment resistance (marrow)

Use for CML with suspected treatment resistance (marrow). Note that the stored DNA sample can be processed if significant problems are confirmed.
The following tests will be performed:

  • Morphology marrow: URGENT
  • Flow cytometry (exclude acute leukaemia)
  • Bone marrow trephine
  • Cytogenetics/FISH (CML progression) marrow
  • Molecular BCR/ABL1 & TKD
  • Molecular (DNA) hold

Pathway 6E: CML possible progression (blood)

Use for CML with suspected progression (blood). The stored DNA can be used for further evaluation if indicated.
The following tests will be performed:

  • Flow cytometry (exclude acute leukaemia)
  • Cytogenetics/FISH (CML progression) blood
  • Molecular BCR/ABL1 & TKD
  • Molecular (DNA) hold