Spot On CML

A Breakthrough Diagnostic Test Offered to Patients With the Greatest Need

Since 2017, The Max Foundation and Dr. Jerry Radich of the Fred Hutchinson Cancer Research Center have partnered to tackle the problem of access to accurate testing for chronic myeloid leukemia (CML) in low- and middle-income countries (LMICs) through a program called Spot On CML.

Dr. Radich has developed a low-cost, paper-based diagnostic testing method for CML. Previously, vials of blood were sent to labs in Europe and the U.S. for testing, which was both costly and unreliable – vials were often damaged in transit. With this new method, a physician spots a patient’s blood onto a test card and sends the card to Dr. Radich’s lab at the Fred Hutch for processing. He and his team are able to perform accurate testing on the samples even after weeks of transport. Once patients are diagnosed, Max connects them with available treatments free of charge. The free treatment is made possible thanks to Max’s partnerships with pharmaceutical companies to provide cancer drugs to patients in need in specified LMICs.

Nearly two years in, Spot On CML has provided access to testing and a pathway to treatment for more than 500 patients in 19 countries.

Spot On CML is an Award-Winning Initiative!

The Max Foundation and Fred Hutch received the Pioneers Outstanding Collaboration award for our work together on Spot On CML! Through our partnership, patients in underserved places were able to gain diagnostic testing and get on a path to access cancer treatment, care, and support. Thank you to Washington Global Health Alliance for honoring us with this award!

This collaboration between The Max Foundation and Fred Hutch goes a long way towards closing the cancer divide. In just over a year’s time, more than 500 people facing cancer have gained access to the right treatment at the right time.

– Pat Garcia-Gonzalez, CEO of The Max Foundation

Without treatment, CML patients live well less than a decade. Thanks to Spot On CML, these patients enjoy a near normal life expectancy. The Max Foundation and Fred Hutch, with assistance from Cepheid and the International CML Foundation, have demonstrated that multiple agencies can cooperate effectively and do enormous good.

–Dr. Jerry Radich, Fred Hutch leukemia researcher and Max Board Member

Read the Award Announcement

Spot On CML Reach and Impact

How the Process Works

The Max Foundation works with our partner physicians to learn about patients in need of CML diagnosis.

Testing supplies, including the Spot On CML test cards, are mailed to the physician for use with the patient.

The physician draws the patient’s blood and spots it onto the test card, then returns the card to The Max Foundation. Meanwhile, the physician registers the patient in the Max patient database.

The Max Foundation transfers the cards to the Fred Hutch for processing at the lab. Depending on the number of cards received, this can take several days.

After receiving the results, a Max representative shares them with the physician. If a patient tests positive, Max will connect the patient with available treatments free of charge.

Tajikistan Case Study

Framing the Unmet Need

Access to accurate diagnostics is a major challenge for many cancer patients in low- and middle-income countries. This is especially true for chronic myeloid leukemia (CML) patients. GeneXperts, the machines used to diagnose CML, run US$10,000-$70,000, even with the preferential pricing offered through The Max Foundation’s collaboration agreement with Cepheid, the manufacturer of the GeneXpert. The cartridges used for each test cost around US$50. At these prices, many health facilities in LMICs cannot afford to provide CML diagnostic testing for their patients. And, without a definitive diagnosis, CML patients are unable to access life-saving drug therapies.

Spot On CML in Tajikistan

The Max Foundation saw this situation firsthand when we visited the National Medical Center in Dushnabe, Tajikistan, in 2017. In speaking with doctors there, we learned that diagnostic testing for CML patients is not available in the country. Instead, patients must pay to have their blood hand-delivered to Moscow for testing. This option, however, is out-of-reach for most in a country where 31% of the population lives below the poverty line. Partner physician Dr. Mirzovali Rahimov estimates that as many as 200 CML patients in Tajikistan lack access to diagnostic testing and, as a result, go without appropriate drug treatment. This situation is not unique to Tajikistan: CML testing capability is limited throughout Central Asia and Central America. Only two countries in sub-Saharan Africa have diagnostic testing for CML.

Physicians from the National Medical Center in Dushnabe, Tajikistan with Erin Lindsay Schneider, Senior Program Manager at The Max Foundation (third from the right) and partner physician, Dr. Mirzovali (far right.)

When we learned that patients in Tajikistan lacked access to diagnostic testing locally, we told Dr. Mirzovali about the Spot On CML program. Spot On CML prioritizes physicians and patients who otherwise lack access to CML diagnostics, making Tajikistan an ideal candidate. Over the following weeks, we coordinated the shipment of testing supplies, and Dr. Mirzovali gathered patients to draw blood samples. By July 2017, the first results came in: 14 Tajikistan patients tested positive for Philadelphia chromosome-positive CML and were immediately approved for drug therapy. Since this initial group of patients, an additional 50 patients have been tested for CML and linked to treatment as needed.

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