CML First Appointment

Your first appointment at Fred Hutchinson Cancer Center is a time for you and your hematologist-oncologist to meet. You might meet your advanced practice provider, too. You will talk about your diagnosis, disease outlook and likely treatment. This visit is also a time for us to start getting to know you as a person. This helps us fit our recommendations to you. Together, you and your care team will decide what needs to happen next.

We encourage you to bring a family member or friend to your first appointment (and any future visits).

Ready to schedule an appointment?

What to Expect

Your first appointment usually takes one hour. Here’s what you can expect to happen.


Confirming Your Diagnosis

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.

doctor reviewing a chart

Talking About Your Disease

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.

doctor writing prescription

Discussing Your Treatment

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.

doctor reviewing notes with patient

Answering Your Questions

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.

Resources for Patients and Caregivers

Here are tips about how to prepare for your first appointment at Fred Hutch and what to bring.

Caregiving at the First Appointment

Just like every patient’s situation is different, every caregiver may be asked to help with different tasks.

As a caregiver, you can give your loved one both emotional and practical support for their first appointment. Ask them if you can help with things like these:

  • Helping them manage their stress, worry or other feelings.
  • Planning how to get to and from the appointment, what time to leave home and where to park.
  • Making a list of questions they want to ask the physician. Fred Hutch’s Guide to Your Care has a list of questions they may want to ask the care team. At the appointment, make sure that all their questions get answered.
  • Taking notes during the visit. The physician will be giving a lot of details, which can be hard to remember later without notes.