What testing is most important to monitor chronic lymphocytic leukemia over time?

As far as monitoring goes,

usually the blood count
alone is what is followed.

And you look at the white blood
cell count and see

whether the lymphocyte proportion
of the white count has normalized.

The other tests, including bone

marrow biopsy, are rarely required.

MRD testing is gaining

importance in chronic lymphocytic leukemia.

When you use certain classes of drugs
like BCL-2 inhibitors that produce deep

responses, how our MRD testing can be done
on the blood in this disease,

and that, again, doesn't
necessarily require a bone marrow biopsy

to establish.

Patients with CLL are monitored 
with mostly blood tests over time,

namely we do the complete blood count

or a CBC that has done that routinely
at every visit.

Another test that's used to monitor over
time is the peripheral blood flow cytometry

that was used in diagnosing a patient
with CLL and the same tests

can be used in monitoring,
tracking the disease as well.

Some of the newer tests
that are used in monitoring disease

Your physician may perform a CT scan

to look for response to the treatment
and sometimes for monitoring the disease.

However,
this is usually not routinely performed

Another highly sensitive test
that is used for monitoring

disease on occasions is minimal
residual disease testing or MRD testing.

However is its use right now is restricted
mostly to the research setting

Initially,
you may need to monitor the patient

even at a weekly interval
after initiation of therapy.

But once the disease
has been well-controlled,

getting a blood test every three months

to four months is sufficient.

During treatment, we routinely
see patients every few months,

sometimes every 2 to 3 months.

And in those locations
we perform the complete

blood count and a flow cytometry test
to monitor patients

once they complete treatment
for the first two years.

After the completion
of the treatment as well.

Some of these tests are performed
every three months

to monitor patients with the disease.

diagnostic testing typically takes
a few weeks, so for the results to come back.