Table 2.
European LeukemiaNet requirements for tyrosine kinase inhibitor discontinuation [22].
Mandatory test results | (i) CML in first CP only (data are lacking outside this setting) |
(ii) Motivated patient with structured communication | |
(iii) Access to high-quality quantitative PCR using the international scale (IS) | |
(iv) Rapid turn-around of PCR | |
(v) Patient's agreement to more frequent monitoring after stopping treatment: monthly for the first 6 months, every 2 months for months 7–12, and every 3 months thereafter | |
| |
Minimal (stop allowed) | (i) First-line therapy or second-line, if intolerance was the only reason for changing TKI |
(ii) Typical e13a2 or e14a2 BCR-ABL1 transcripts | |
(iii) Duration of TKI therapy >5 years (>4 years for 2G-TKI) | |
(iv) Duration of DMR (MR4 or better) > 2 years | |
(v) No prior treatment failure | |
| |
Optimal (stop recommended for consideration) | (i) Duration of TKI therapy >5 years |
(ii) Duration of DMR >3 years if MR4 |
CML: chronic myeloid leukaemia; CP: chronic phase; PCR: polymerase chain reaction; TKI: tyrosine kinase inhibitor; DMR: deep molecular response; MR4: molecular response with log 4 reduction in BCR/ABL transcripts.