Myeloproliferative neoplasms (MPN/CML)

The identification of BCR-ABL rearrangement is critical in establishing a diagnosis of chronic myeloid leukaemia (CML), and in identifying patients who are eligible for treatment with the tyrosine kinase inhibitors (TKI) imatinib, dasatinib and nilotinib. Cytogenetic monitoring of these patients to assess response to therapy is standard-of-care, and time to achieve complete cytogenetic remission has been shown to be predictive of long-term outcome and the possible need to switch therapy to an alternative TKI. In other myeloproliferative neoplasms (MPN), cytogenetic abnormalities detected can help in the establishment of a diagnosis of MPN, and can then be used in disease monitoring, where clonal evolution may indicate disease progression. Karyotype analysis is a requirement for a number of clinical trials. Certain specific abnormalities i.e. PDGFRα and FGFR1 rearrangement also identify patients who may respond to specific TKI's.