CML First Appointment

Most of our new patients have already had blood tests that show they have chronic myeloid leukemia (CML). Many were recently diagnosed. Others have had CML treatment elsewhere and are looking for new options. If you haven’t had the blood tests you need, we may ask you to come in for these before your first appointment.

We start by checking your diagnosis. An experienced Fred Hutch hematopathologist looks carefully at your pathology slides. Knowing details about your CML is important because it helps your physician predict how your disease might behave and which treatments will likely work best for you.

Our hematopathologists may run more tests on your blood or bone marrow to confirm your diagnosis or look for features of your CML that matter for your care. At your first appointment, your physician will have your results and go over them with you.

Your physician will explain what CML is and how it typically behaves over time. They will talk with you about how the disease is affecting your body, and they will describe what happens for most people in your situation with or without treatment.

Physicians group CML into three phases — chronic, accelerated and blast — based mainly on the percentage of immature white blood cells (blasts) in the blood and bone marrow. Knowing the phase helps your team choose the best treatments for you. Your physician will explain what your CML phase means.

Most new patients are in the chronic phase. In this phase, the percentage of blasts is abnormal but low. In the accelerated phase, the percentage is higher, and you might have other signs and symptoms. In the blast phase, the percentage is even higher, and the disease acts more like acute leukemia.

The goal of CML care is to give you a normal lifespan with the best possible quality of life. The treatment we recommend for you will depend on your CML phase and many other things, like your age and health. If your CML has already been treated elsewhere, we will also consider which therapies you had, how your disease responded and if you had side effects.

Based on your test results so far (and any previous treatment), your physician will explain the treatments you are likely to need. If you need any other tests to tell us more about your disease, we will talk about your treatment again in more detail after we have the results.

These appointments are also a time for you to tell us about yourself. Each patient and family has their own needs and preferences. We want to get to know you so we understand the best way to care for you.

Starting with your first appointment (and after), we are here to answer your questions. We want to help you understand as much as you want to know about your disease, your treatment and how care happens at Fred Hutch. We invite you to bring a friend or family member with you to help keep track of your questions and the information that your team gives you.

We also encourage you to talk with your care team about your hopes and concerns. Knowing more about you helps your team recommend the right treatment for you.

Before you leave, we will make sure you know what is going to happen next and how you can reach us if you have questions later. We will also schedule your next visit.