Chronic myelogenous leukemia: Laboratory diagnosis and monitoring

Rapid developments have occurred both in laboratory medicine and in therape utic interventions for the management of patients with chronic myelogenous leukemia (CML). With a wide array of laboratory tests available, selecting the appropriate test for a specific diagnostic or therapeutic setting has b ecome increasingly difficult. In this review, we first discuss, from the po int of view of laboratory medicine, the advantages and disadvantages of sev eral commonly used laboratory assays, including cytogenetics, fluorescence in situ hybridization (FISH), and qualitative and quantitative reverse tran scriptase-polymerase chain reaction (RT-PCR). We then discuss, from the poi nt of view of clinical care, the test(s) of choice for the most common clin ical scenarios, including diagnosis and monitoring of the therapeutic respo nse and minimal residual disease in patients treated with different therapi es. The purpose of this review is to help clinicians and laboratory physici ans select appropriate tests for the diagnosis and monitoring of CML, with the ultimate goal of improving the cost-effective usage of clinical laborat ories and improving patient care. (C) 2001 Wiley-Liss, Inc.