Figure 2.
Treatment response and potential uses of emerging technologies. A conjecture on how tests may be used in the future to guide CML (and other hematological malignancies) therapy, based on current research work in the field (ignoring any financial considerations). At diagnosis, DNA methods can be used to both quickly determine breakpoints useful in designing DNA monitoring assays and other mutations that might influence initial response to TKI therapy. RNA sequencing (RNA seq) can used to assay specific genes and pathways associated with early response. Single-cell genetics can be used to establish potentially troublesome complex heterogeneity and identify populations with a resistance signature. During therapy, digital and DNA PCR can be used as a more sensitive determinant of deep molecular response, and “NGS+” used to identify mutations in patients without a deep response who appear to be relapsing.