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Cancer

Monitoring and Adherence in CML

Summary & Participants

Imatinib, or Gleevec, is a targeted anti-cancer drug that can keep chronic myelogenous leukemia (CML) in check for most patients for many years. It is important for patients to take imatinib as prescribed by their doctor to fight the disease and to guard against resistance.

Medically Reviewed On: July 21, 2008

Webcast Transcript

ANNOUNCER: Treatment for many patients with chronic myelogenous leukemia or CML can be so effective experts say it can now be managed as a chronic condition.

PATRICIA JAKEL, RN, MN, AOCN: It’s like having diabetes, it’s like having heart disease, that you need treatment for long periods of time. We may not cure you, but we’re going to keep your disease in check and in remission.

MICHAEL MAURO, MD: When the disease is in remission, there’s very little to remind you that you even have leukemia. Many of my patients will say, “If I didn’t have to take that pill once a day, I wouldn’t remember, really, that I had leukemia.” On the flip side, our task is to make sure that we do whatever we can to help patients remember and to understand that compliance is crucial to maintaining response.

ANNOUNCER: The pill is imatinib or Gleevec, a targeted anti-cancer drug. While imatinib will keep the CML in check for most patients for many years, infrequently, relapse can occur.

CAROLYN BLASDEL, RN, FNP, OCN: Cancers are notorious for developing resistance to treatment, and it’s thought that by suboptimal dosing -- in other words, by having inadequate levels of Gleevec in your blood that this gives the cancer a chance to figure out ways to get around the drug, and we call that resistance.

ANNOUNCER: It is important for patients to take imatinib as prescribed by their doctor to fight the disease and to guard against resistance. Regularly scheduled monitoring helps doctors and patients know if the medicine is working and if patients are reaching treatment goals.

JORGE CORTES, MD: The issue of monitoring has become more and more relevant, because the better treatment options you have for a patient, the more critical it is that you make sure that the goals that you want for a patient are met, and if not, that you do something to improve that.

CAROLYN BLASDEL, RN, FNP, OCN: Typically when people are diagnosed with CML, their white blood count’s quite high. It could be 50,000, it could be 300,000. But normally within the first month, those counts go back to normal.

ANNOUNCER: Blood tests should be conducted every week or two until patients achieve a complete hematologic response. When blood counts normalize doctors will continue to monitor patients’ progress every six months with cytogenetic testing to check what impact the treatment is having on the underlying disease.

CAROLYN BLASDEL, RN, FNP, OCN: The gold standard for CML is a bone marrow biopsy and aspiration, and with a bone marrow, we can look at what’s actually going on inside the marrow, where blood is produced, and in particular cytogenetics. And CML is caused by a translocation between chromosomes 9 and 22. So when we do a bone marrow biopsy, we’re looking for that. Is it present?

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