Table 2.
Time since start of TKI treatment | ELN response category | |||||
---|---|---|---|---|---|---|
Optimal | Warning | Failure | ||||
Response criteria | Monitoring | Response criteria | Monitoring | Response criteria | Monitoring | |
Baseline | NA | CBA, Qualitative PCR | High risk or CCA/Ph+, major route | CBA, Qualitative PCR | NA | CBA, Qualitative PCR |
3 months | BCR‐ABL1 ≤10% and/or Ph+ ≤35% | RT‐qPCR every 3 months until MMR, then every 3–6 months and/or CBA at 3, 6 and 12 months until CCyR, then FISH | BCR‐ABL1 >10% and/or Ph+ 36–95% | Molecular/cytogenetic tests to be performed more frequently (up to monthly)b | No CHR and/or Ph+ >95% | RT‐qPCR, mutational analysis, and CBA should be performed. Immunophenotyping in blastic phase. |
6 months | BCR‐ABL1 <1% and/or Ph+ 0 | BCR‐ABL1 1–10% and/or Ph+ 1–35% | BCR‐ABL1 >10% and/or Ph+ >35% | |||
12 months | BCR‐ABL1 ≤0·1% | BCR‐ABL1 >0·1–1% | BCR‐ABL1 >1% and/or Ph+ >0 | |||
≥12 months | BCR‐ABL1 ≤0·1% |
CCA/Ph−
(−7, or 7q−) |
Loss of CHR, Loss of CCyR, confirmed loss of MMRc |
CBA, chromosome banding analysis of marrow cell metaphases; CCA/Ph+, clonal chromosome abnormalities in Philadelphia chromosome‐positive cells; CCA/Ph−, clonal chromosome abnormalities in Philadelphia chromosome‐negative cells; CCyR, complete cytogenetic response; CHR, complete haematological response; CML, chronic myeloid leukaemia; ELN, European LeukaemiaNet; FISH, fluorescence in situ hybridisation; MMR, major molecular response; NA, not applicable; PCR, polymerase chain reaction; Ph, Philadelphia chromosome; RT‐qPCR, reverse transcriptase quantitative polymerase chain reaction.
The definitions are the same for patients in chronic phase, accelerated phase and blast phase and also apply to second‐line treatment, when first‐line treatment was changed for intolerance.
CBA recommended in case of myelodysplasia or CCA/Ph‐ with chromosome 7 involvement.
In two consecutive tests of which one is with a BCR‐ABL1 transcript level of ≥1%.