This map explains chronic myeloid leukaemia (CML) step by step: what it is, the types, the tests, the stages, the treatment and its side effects.
Tap any topic on the map to read about it. Topics with an arrow open more topics.
CML has three phases. Tap a phase on the map.
About 9 out of 10 patients are diagnosed in this phase. Controlled very well with tablets.
More blasts or new genetic changes. Needs stronger treatment.
Behaves like acute leukaemia. Treated with TKIs plus chemotherapy, and a transplant if possible.
Tap a test on the map to see why it is done.
A complete blood count and a look at the blood under the microscope (peripheral smear). Often the first sign of the disease.
A blood test that measures the amount of BCR-ABL. Done at diagnosis and every 3 months to check treatment is working.
Confirms the diagnosis and phase, and checks for extra chromosome changes.
Measured by examination or ultrasound; it shrinks with treatment.
Before starting chemotherapy, immunotherapy or targeted therapy, these tests check that you are fit for treatment, and give a starting point to compare with later.
| Test | Why it is done |
|---|---|
| CBC (complete blood count) | Haemoglobin, white cells and platelets. Treatment can lower them. |
| RFT (kidney function) | Many medicines are cleared by the kidneys; the dose may need to change. |
| LFT (liver function) | Many medicines are processed by the liver. |
| Viral markers: HBsAg, anti-HCV, HIV | Hepatitis B can flare up during treatment. If positive, a tablet is given to prevent this. |
| Blood sugar (and HbA1c if diabetic) | Steroids given with chemotherapy can raise blood sugar. |
| ECG and 2D Echo | Check the heart rhythm and pumping before treatment, as some medicines affect the heart. |
Before immunotherapy, also:
| Test | Why it is done |
|---|---|
| Serum TSH (thyroid) | Immunotherapy can affect the thyroid gland. |
| Serum cortisol (morning sample) | Immunotherapy can affect the adrenal and pituitary glands. |
Sometimes needed, depending on your treatment:
Your doctor will choose the tests that apply to you. Some of them are repeated during treatment.
Response is measured by BCR-ABL PCR. Tap a milestone on the map.
BCR-ABL 10% or less.
BCR-ABL less than 1%.
BCR-ABL 0.1% or less: major molecular response (MMR). Patients at this level do very well.
Tap a topic on the map.
Side effects: TKI tablets
Side effects: TKI tablets
Tap a treatment on the map.
Breathlessness, chest pain, fever, bleeding, or severe swelling need urgent care.
This information is general. Your own treatment plan may be different. Please discuss it with your doctor.
Written and medically reviewed by Dr Prathyusha Eaga, MD, DM (Medical Oncology). Last reviewed: 12 October 2026. Based on NCCN and ESMO guidelines.
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