Glossary
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- Absolute Basophil Count
- The total number of basophils in a sample of peripheral blood. It is calculated by multiplying the percentage of basophils (in decimal form) by the total number of white blood cells.
- AMN107
- New Novartis inhibitor - Phase 1 in US and Germany and shortly to start Phase 2 in the UK and Europe
- Absolute Neutrophil Count (ANC)
- The total number of neutrophils in a sample of peripheral blood. It is calculated by multiplying the percentage of neutrophils (in decimal form) plus the percentage of bands (in decimal form) by the total number of white blood cells. The number of bands is usually quite low or even zero, so one may also obtain a fairly accurate ANC by leaving the percent of bands out of the equation. ANC of less than 1 k/ul may indicate stoppage of Gleevec therapy to allow the neutrophil counts to recover. Low ANC puts the patient at risk of infection since there is now less of the white blood cells that fight infections in the body. (neutrophils)
- Accelerated Phase
- CML is characterized by two to three phases or stages. The second, intermediate phase is called the Accelerated Phase and usually lasts from 6 to 9 months. The Accelerated Phase does not occur in all patients as some transition directly from Chronic Phase CML to Blast Crisis. Accelerated Phase is characterized by an elevated WBC, but will exhibit one or more of the following markers: greater than 20% basophilia, a hemoglobin level of 7.0 gm/dl or less, platelets 100K/mm3 or less and 15% to 30% myeloblasts. The appearance of myelofibrosis and/or clonal change often indicates progression to Accelerated Phase.
- Albumin
- A protein made in the liver. Very low levels of albumin may be a sign of liver damage. The normal albumin range is from 3.9 gm/dL (grams per decileter) to 5.0 gm/dL.
- Alkaline phosphatase (ALP)
- An enzyme found in the liver. Abnormally high ALP levels may indicate liver problems. The normal range of ALP is between 30 IU/L and 115 IU/L. However, ALP is not specific to the liver and sometimes an elevated ALP count can indicate activity in the bone marrow like the fast killing of leukemic cells.
- Allogenic Transplant
- Bone marrow or stem cell transplant in which the donor is a matched donor of the patient.
- ALT
- An enzyme made in the liver called transaminase. ALT is sometimes called SGPT. The normal range of ALT levels is between 5 IU/L and 60 IU/L. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity). Usually, an ALT of a 5-fold increase of the upper limit of the normal range is an indication of stoppage of Gleevec.
- Anasarca
- A condition of generalized edema or swelling due to excessive fluid retention.
- ANC
- Abbreviation for Absolute Neutrophil Count. Normal range is 1.0 – 8.0 k/ul.
- Anemia
- Can be of different types and generally indicates a condition in which the number of red blood cells (erythrocytes) is lower than normal and the number of oxygen carrying red cells (hemoglobin) is less than normal. A common symptom of anemia is fatigue. Usually a hemoglobin count of less than 9-10 g/dl is indicative of anemia and this can happen on Gleevec therapy as a side-effect. Some doctors prescribe growth factors like Aranesp (see below) to raise the red blood cell counts. Others can sometimes prescribe blood transfusion especially if the count is very low like 6-8 g/dl.
- Aranesp
- A long-acting growth factor that can help prevent anemia (low red blood cell and hemoglobin counts), caused by chemotherapy/IM therapy. It grows red blood cells.
- Ascites
- A condition in which there is abnormal fluid in the abdomen.
- AST
- An enzyme made in the liver. AST is sometimes called SGOT. The normal range of AST levels is between 5 IU/L and 43 I/UL. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity). Again, a five-fold increase of the upper limit of the normal range may warrantee stoppage of Gleevec therapy.
- Autologous Transplant
- A bone marrow or stem cell transplant using the patient's own stem cells. These stem cells are harvested from the patient when the patient is in remission and stored in the freezer. It is reinfused back into the patient after killing the patient’s diseased marrow by chemotherapy.
- Bands
- Immature neutrophils
- Basophil
- A type of white blood cell involved in inflammatory and allergic responses. Its role in CML is not well understood, but elevated basophil counts are characteristic of CML. Normal range is 0 – 2%. An elevated or increasing basophil count can also be indicative of CML disease progression.
- Basophilia
- Higher than normal number of basophils in the bone marrow or peripheral blood.
- Bcr-Abl
- A gene and also a protein created by the translocation of Chromosomes 9 and 22.
- Bilirubin
- A yellow fluid produced in the liver. Elevated bilirubin levels can cause a condition called jaundice in which the eyes and skin appear yellow, urine becomes very dark and feces are light. There are two measures of bilirubin: Total Bilirubin, which measures the amount of bilirubin in the bloodstream and Direct Bilirubin, which measures the amount of bilirubin made in the liver. Normal total bilirubin levels range from .20 mg/dL to 1.50 mg/dL. Normal direct bilirubin levels range from .00 mg/dL to .03 mg/dL
- Blasts
- Immature white blood cells found in the bone marrow and not normally in the peripheral blood. Also called myeloblasts. Normally there are 0% blasts in the peripheral blood and 0-5% blasts in the bone marrow. 15% blasts or more in the blood or marrow is indicative of accelerated phase of CML. 30% blasts or more in the blood or marrow indicates blast crisis, the terminal phase of CML.
- Blast Crisis
- CML is characterized by two to three phases or stages. The third, most severe phase is called the Blast Crisis and lasts from 3 to 6 months. Blast Crisis is characterized by elevated WBC; usually a decreased platelet count, the presence of more than 30% of myeloblasts in the peripheral blood or bone marrow, and tissue infiltrates of leukemic cells which may involve chloromas.
- BMA
- Abbreviation for Bone Marrow Aspiration. A BMA sucks out the marrow and cytogenetic analysis is done on the sample to calculate the percentage of Ph chromosome.
- BMB
- Abbrevision for Bone Marrow Biopsy. BMB sample consists of the marrow and bone chip so that the bone marrow full morphology can be examined.
- BMS
- Bristol Myers Squibb - the new inhibitor currently being trialled in the US and very shortly in Phase 2 in the UK and Europe. Very promising in the treatment of Glivec resistant CML. Read Jerry's Diary
- BMT
- Abbreviation for Bone Marrow Transplant.
- Bone Marrow
- The soft, spongy tissue found in the center of most large bones that produces the white cells, red cells and platelets.
- Bone Marrow Aspiration
- The removal by suction of fluid from the bone marrow.
- Bone Marrow Biopsy
- A method of removing a small sample of bone marrow and bone chip from the body to have it examined under a microscope and possibly analyzed by other tests.
- Bone Marrow Transplant
- Procedure to replace the diseased bone marrow from a sick patient with the healthy bone marrow from a donor. The diseased marrow in the patient is killed by intense chemotherapy (and sometimes total body radiation) and then the donor’s stem cells or bone marrow cells are infused into the patient to engraft and start producing healthy blood cells.
- CBC
- Abbreviation for Complete Blood Count.
- Cerebral Edema
- A condition in which there is extra fluid and swelling in the brain.
- Chloromas
- Collections of tumorous cells within the skin or other body parts.
- CHR
- Abbreviation for Complete Hematological Response or Remission.
- Chromosomal Damage
- Mutations or abnormal changes in a chromosome, often indicative of disease progression.
- Chronic Phase
- CML is characterized by two to three phases or stages. The first stage is called the Chronic Phase and usually lasts from 5 to 6 years. The vast majority of patients (85% to 90%) are diagnosed while in the Chronic Phase. Very often, individuals in the Chronic Phase have no or few symptoms and are diagnosed through a routine blood test. Some people in the Chronic Phase experience symptoms such as fatigue, shortness of breath, feeling of fullness or pain in the upper left side of the abdomen (due to enlarged spleen), weight loss, night sweats and anemia. Typical features of Chronic Phase are: elevated white blood cell (WBC) count; normal or high platelet count; increased basophil count; sometimes increased eosinophil count; and, most importantly, fewer than 15% myeloblasts. In the Chronic Ph
- Clonal Change
- Abnormal changes within the chromosomes, often indicative of disease progression..
- Complete Blood Count (CBC)
- The number of white blood cells, red blood cells and platelets in the patient's sample of blood is determined.
- Complete Hematological Response (CHR)
- See hematological remission.
- Conventional Cytogenetics
- Analysis by microscope of individual cells for the presence or absence of abnormal chromosomes (for example, the Philadelphia Chromsome). The process is very time consuming and is usually conducted on 20 marrow metaphase or dividing cells.
- Cytogenetic Relapse
- A significant increase of the order of 30% in the percentage of Philadelphia Chromosome present in the bone marrow or peripheral blood of a CML patient.
- Cytogenetic Remission
- Absence of Philadelphia Chromosome by bone marrow chromosomal analysis, or by FISH analysis of the bone marrow or peripheral blood.
- Cytogenetic Response
- The reduction in or the elimination of the number of cells expressing the Philadelphia Chromosome in a CML patient.
- Differential Count
- A test that measures the relative numbers of white blood cells (WBCs) in the blood; it also includes information about abnormal cell structure and the presence of immature cells (Blasts or myeloblasts).
- Direct Bilirubin
- The amount of bilirubin (a yellow fluid) made in the liver. Normal direct bilirubin levels range from .00 mg/dL to .03 mg/dL. See also Total Bilirubin.
- Edema
- Swelling due to excessive fluid retention.
- Eosinophilia
- Higher than normal number of eosinophils in the bone marrow or peripheral blood.
- Eosinophils
- A type of white blood cell involved in allergic responses and parasitic infections.
- Erythrocytes
- Red Blood Cells.
- FISH
- Common abbreviation for Fluoresence In Situ Hybridization. A method using DNA probes for determining many chromosomal abnormalities associated with CML by analyzing peripheral blood or bone marrow. FISH usually looks at standard 200 interphase cells, and is thus more sensitive than conventional chromosomal analysis. FISH does not look at dividing or metaphase cells.
- Genotoxic
- Chemicals capable of causing damage to DNA.
- Gleevec
- A tyrosine kinase inihibitor used to treat chronic myeloid leukemia. Also called imatinib mesylate, IM and Glivec.
- Glivec
- A tyrosine kinase inihibitor used to treat chronic myeloid leukemia. Also called imatinib mesylate, IM and Gleevec.
- Graft versus Host Disease
- A condition that occurs following bone marrow or stem cell transplant in which the donor's immune cells, in the transplanted marrow, make antibodies against the host's (patient recipient’s) tissues.
- Growth Factors
- Agents or medicines that stimulate one’s body to produce certain types of cells (neutrophils, platelets, red blood cells)
- Hematocrit
- The hematocrit measures how much space in the blood is occupied by red blood cells. It is useful when evaluating a person for anemia. The normal range for hematocrit is 40.0% to 52.0%.
- Hematological Remission
- Normal blood counts in a CML patient generally reflected in non-elevated white blood cells, platelets and basophils. A patient is said to have achieved complete hematological remission on Gleevec when the white blood count is below 10,000 and the platelets in normal range and with basophils and blasts in the normal range.
- Hematuria
- A condition in which there is blood in the urine.
- Hemoglobin
- The red pigment in red blood cells their color. It functions to carry oxygen from the lungs to the rest of the body. The normal range for hemoglobin is 13 to 18 gm/dL for males and 11.5-16.5 gm/dL for females.
- Hepatotoxicity
- Condition in which liver function has been harmed by a chemical agent. Also called liver toxicity.
- HGB
- Abbreviation for hemoglobin.
- HLA (Human Leukocyte Antigens) Typing
- A blood test that determines a person's compatability for purposes of a bone marrow or stem cell transplant based on the types of antigens present.
- Hydrea/Hydroxyurea
- One of the older anti-cancer drugs. It is often used in newly diagnosed CML patients to destroy the leukemia cells and lower the white blood cell count. It rarely brings any cytogenetic response.
- Hypercellular
- In CML, refers to the fact that there is an overabundance of certain kinds of cells in the bone marrow. Hypercellular marrow is particularly common at diagnosis and early in the course of IM treatment in CML patients.
- Hypocellular
- In CML, refers to the fact that there is a decreased number of certain kinds of cells in the bone marrow. Hypocellular marrow is particularly common with continued IM treatment in CML patients.
- IFN
- Abbreviation for interferon.
- Interferon
- An agent used to treat CML and other diseases and cancers.
- IM
- Abbreviation for Imatinib Mesylate, a tyrosine kinase inhibitor used to treat chronic myeloid leukemia (CML). Also called Gleevec and Glivec.
- Imatinib Mesylate
- A tyrosine kinase inihibitor used to treat chronic myeloid leukemia. Also called IM, Gleevec and Glivec.
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- Karyotype
- Chromosome analysis.
- Leukocyte
- A white blood cell.
- LFTs
- Abbreviation for Liver Function Tests.
- Liver Function Tests
- A group of blood tests that can help to show how well a person's liver is working. LFTs include measurements of albumin, various liver enzymes (ALT, AST, GGT and ALP), bilirubin, prothrombin time, cholesterol and total protein. All of these tests can be performed at the same time.
- Liver Toxicity
- Condition in which liver function has been harmed by a chemical agent. Also called hepatotoxicity.
- Major Cytogenetic Response (MCR)
- A reduction in the percentage of cells expressing the Philadelphia Chromosome to 35% or less in a CML patient.
- Minor Cytogenetic Response
- A reduction in the percentage of cells expressing the Philadelphia Chromosome to a level between 36%-95% in a CML patient.
- Molecular Remission
- Absence of Bcr-Abl transcripts in the peripheral blood or bone marrow by PCR testing. This is the highest degree of remission for CML patients to achieve with the testing procedures available.
- MR
- Abbreviation for Molecular Remission.
- MUD
- Abbreviation for Matched, Unrelated Donor (for bone marrow or stem cell transplant). This is a non-family member whose HLA matches the patients’ HLA.
- Myeloblasts
- An immature cell found in the bone marrow and not normally in the peripheral blood. Normally there are 0% myeloblasts in the peripheral blood and 0-5% blasts in the bone marrow.
- Myelofibrosis
- A condition in which the marrow of the bone is replaced with fibrous (scar) tissue.
- Myelosuppression
- A decrease in the ability of the blood cell-producing tissues of bone marrow to produce all types of blood cells, especially neutrophils and platelets.
- Myelosuppressive
- Causes a decrease in the ability of the bone marrow to produce cells.
- Neumega
- A platelet growth factor that can help prevent extremely low platelet counts caused by chemotherapy/IM therapy.
- Neupogen
- A growth factor that can help prevent extremely low neutrophil counts caused by chemotherapy/IM therapy.
- Neutropenia
- The condition of having abnormally low numbers of one type of white blood cell called neutrophils.
- Neutrophil
- A type of white blood cell largely responsible for fighting infection. Normal range for neutrophils is 45.0% to 70.0%.
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- PCR
- Common abbreviation for Polymerase Chain Reaction. A very sensitive test used to detect very low levels of bcr-abl transcripts in marrow or peripheral blood stem cells. The test involves analysis of bone marrow or peripheral blood to determine the presence and/or quantification of Bcr-Abl transcripts.
- Peripheral Blood
- The blood that circulates throughout the body.
- Ph or Ph+
- Abbreviation for Philadelphia Chromosome and Philadelphia Chromosome positive (meaning that the Philadelphia Chromosome is present)
- Philadelphia Chromosome
- Refers to the short chromosome 22 which occurs when there is exchange of genetic materials between chromosomes 9 and 22. This chromosomal mutation is characteristic of most patients (90%) with CML.
- Platelet Transfusion
- The process of giving platelets from a donor to a patient with very low platelets.
- Platelets
- A type of blood cell formed in bone marrow that helps prevent bleeding by causing blood clots to form. Normally, platelet counts range from 150 to 450 k/ul.
- Pericardial Effusion
- A condition in which fluid surrounds the cavity around the heart.
- Procrit
- A growth factor that can help prevent anemia (low red blood cell and hemoglobin counts), caused by chemotherapy/IM therapy.
- Pulmonary Edema
- A condition in which there is fluid in the lungs.
- Qualitative PCR
- A very sensitive test that detects the presence or absence of Bcr-Abl in the marrow or peripheral blood.
- Quantitative PCR
- A very sensitive test that quantifies the amount of Bcr-Abl in the marrow or peripheral blood.
- Red Blood Cells
- Cells that carry oxygen to all parts of the body through hemoglobin.
- Reference Range
- The lower and higher end of values considered normal for a laboratory test. All laboratory results which show counts at the lower or higher ends, or anywhere in between, are considered normal.
- Relapse
- A loss of response, usually marked by the loss of hematological remission, an increase in the percentage of Philadelphia chromosome or a significant increase in the percentage of Bcr-Abl transcripts in a CML patient.
- Remission
- A decrease in, or disappearance of, signs and symptoms of an illness. In partial remission, some, but not all, signs or symptoms of cancer have disappeared. In complete remission, all signs or symptoms of cancer have disappeared, although there still may be cancer in the body.
- SCT
- Abbreviation for Stem Cell Transplant.
- SGOT
- An enzyme made in the liver. SGOT is sometimes called AST. The normal range of SGOT leels is between 5 IU/L and 43 I/UL. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).
- SGPT
- An enzyme made in the liver. SGPT is sometimes called ALT. The normal range of SGPT levels is between 5 IU/L and 60 IU/L. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).
- Spleen
- A large organ to the left of the stomach and below the diaphragm, serving to store blood, disintegrate old blood cells, filter foreign substances from the blood, and produce lymphocytes(white blood cells). An enlarged spleen is a common finding at CML diagnosis.
- Stem Cells
- Cells from which other types of cells can develop.
- Stem Cell Transplant
- Procedure to replace the diseased bone marrow from a sick patient with the healthy stem cells from a donor.
- Thrombocytopenia
- The condition of having abnormally low numbers of platelets.
- Thrombocytosis
- The condition of having abnormally high numbers of platelets.
- Tissue Infiltrates
- Tumorous cells that invade the skin or other body parts.
- Total Bilirubin
- Measures the amount of bilirubin (a yellow fluid made in the liver) in the bloodstream. Normal total bilirubin levels range from .20 mg/dL to 1.50mg/dL. See also Direct Bilirubin.
- Total Protein
- The amount of proteins in the bloodstream measured in liver function tests (LFTs). Normal total protein levels in the bloodstream range from 6.5 to 8.2gm/dL
- Transaminases
- Enzymes made in the liver. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).
- Translocation
- In terms of cancer, refers to parts of chromosomes breaking off and switching places with each other, thereby causing abnormal function (see Philadelphia Chromosome)
W...
- WBC
- Abbreviation for White Blood Cell.
- White Blood Cell
- A blood cell that does not contain hemoglobin. White blood cells are made by bone marrow and help the body fight infection and other diseases, as part of the immune system.
- White Blood Cell (WBC) Count
- Counting the number of white blood cells, usually as part of a complete blood count (CBC). Normally, WBC should range between 4.0 and 11.0 k/ul.
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