6.1 Signs and symptoms of refractory or relapsed disease

6.1 Signs and symptoms of refractory or relapsed disease

Nearly all patients with CML are asymptomatic, so refractory or relapsed disease is generally picked up during monitoring of molecular response. This can be assessed using the ratio of BCR-ABL1 transcripts to the control gene transcripts. According to the European LeukemiaNet

2020 recommendations for treating CML, a BCR-ABL1 of greater than 10 per cent at three months indicates treatment failure when confirmed (Hochhaus et al. 2020).