Table 1.

Criteria for Discontinuing TKIs Based on Expert Recommendations and Guidelines

	ESMO	NCCN	French Chronic Myeloid Leukemia Study Group	Hughes			ELN 2020
				Green	Yellow	Red
BCR-ABL1 transcript	Typical, measurable	Typical, measurable	e13a2, e14a2, or e13a2 + e14a2	Typical, measurable	Atypical, measurable	Not measurable	Typical, measurable
CML history	Chronic phase	Chronic phase	Chronic phase	Chronic phase	Resistance	Accelerated/or KD mutationblast phase	Chronic phase
Sokal score	Not high	/	/	Not high	High	/
Response to first-line TKI	Optimal	No resistance	No allogeneic HSCT, progression, resistance, suboptimal response, or warning	Optimal	Warning	Failure	Minimal criteria: no prior treatment failure (except intolerance to first-line TKI)
DMR	≤MR4.5	≤MR4.0	≤MR4.5	≤MR4.5	≤MR4.0	>MR4.0	≤MR4.0
Duration of DMR	≤MR4.0 ≥2 y	≥ 2 y	≥ 2 y	≥ 2 y	1-2 y	< 1 y	Optimal criteria: >3 y if MR4.0, >2 y if MR4.5 Minimal criteria: >5 y (>4 y for 2GTKI)
Duration of TKI	≥ 5 y	≥ 3 y	≥5 y	≥ 8 y	3-8 y	< 3 y	Optimal criteria: >5 y Minimal criteria: ≥MR4.0 for >2 y
Retreatment	/	Loss of MMR	Loss of MMR	/	/	/	Within 4 weeks of MMR loss
Frequency of monitoring	Monthly during the first half-year, every 6 weeks during the second half-year, and every 3 months later on	Monthly for the first 12 mo, every 6 wk during mo 13 24, and every 12 wk thereafter	Monthly during the first 6 mo, every 2 mo from 7-12 mo, quarterly during the second year, and then every 3-6 mo	Monthly during the first 6 mo, every 2-3 mo later on			Monthly during the first 6 mo, every 2 mo from 7-12 mo, and then every 3 mo

CML, chronic myeloid leukemia; DMR, deep molecular response; ESMO, European Society for Medical Oncology; HSCT, hematopoietic stem cell transplant; MMR, major molecular response; mo, months; MR4.0, BCR/ABL1 ratio <0.01%; MR4.5, BCR/ABL1 ratio <0.0032%; TKI, tyrosine kinase inhibitor; wk, weeks; y, years.