Chronic myeloid leukemia: state-of-the-art management

Abstract

Treatment-free remission leading to a sustained deep molecular response (DMR) following the discontinuation of tyrosine kinase inhibitor (TKI) is a therapeutic goal in patients with chronic myeloid leukemia chronic phase (CML-CP). In 2017, discontinuing TKI treatment at the outside of clinical trials was recommended for the first time by National Comprehensive Cancer Network guidelines. The criteria for TKI discontinuation include at least 3 years of TKI therapy, a stable DMR for ≥2 years, and monthly molecular monitoring during the first 6 months following discontinuation of treatment. Moreover, discontinuing TKI treatment at the outset of clinical trials may soon be recommended by the Japanese CML guidelines. Thus, achieving a sustained DMR is the current focus of research in CML-CP patients without a history of TKI resistance.