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Significant progress to increase diagnosis and monitoring of CML in emerging regions

Many hospitals in developing countries do not have the capability to confirm the diagnosis of CML either by cytogenetics or by molecular tests, which results in patients not being able to access the medication available to enhance and extend their quality of life. Moreover once treatment has started, continued monitoring is essential to detect early evidence of drug resistance, or disease progression, that in many cases could be better managed with a change in therapy.

Through the ERSAP Diagnosis and Testing Program the iCMLf will help clinicians in emerging regions use objective testing to confirm CML diagnosis via FISH, cytogenetics, or PCR to detect the BCRABL1 gene, or transcripts. Partnerships will be established between CML doctors and centres in emerging regions and staff at international CML centres of excellence to develop diagnostic and monitoring services. No single model of how this will work optimally is assumed. It is likely that solutions will differ according to the local situation. The strategic placement of an automated instrument in a centre plus the provision of appropriate training and support may be an effective solution in one centre, whereas in another situation training of local technicians to establish and maintain an in-house assay may be the most cost-effective way to establish a local service.

The longterm goal for this program is to provide equipment and training for clinical and laboratory staff at the local level. This would allow specific centres in emerging regions to become self-sufficient to monitor their own CML patients and eventually patients at other local centres. In this way the iCMLf, will develop a multifaceted approach to build sustainable local capacity for CML Diagnosis and Testing while ensuring adequate on going support from clinical and laboratory mentors. With this in mind this program will go a long way towards meeting the objective of equal access to monitoring around the world.

"I am really happy that iCMLf has come up with an innovative program and I am very confident that this will help save a lot of lives around the whole world."
Dr Kayastha, Kathmandu, Nepal