Table 2.

European LeukemiaNet 2020 recommendations: requirements for tyrosine kinase inhibitor discontinuation

MandatoryMinimalOptimal
CP-CML First-line TKI or second-line TKI if motivated by intolerance to first-line drug Duration of therapy >5 y 
Real time quantitative polymerase chain reaction on the IS scale Typical e13a2 or e14a2 BCR-ABL1 transcripts DMR duration >3 y if MR4 
Patient motivation and adherence Duration of therapy >5 y if imatinib >4 y if second-generation TKI DMR duration >2 y if MR4.5 
 DMR duration (MR4 or M4.5) >2 y  
MandatoryMinimalOptimal
CP-CML First-line TKI or second-line TKI if motivated by intolerance to first-line drug Duration of therapy >5 y 
Real time quantitative polymerase chain reaction on the IS scale Typical e13a2 or e14a2 BCR-ABL1 transcripts DMR duration >3 y if MR4 
Patient motivation and adherence Duration of therapy >5 y if imatinib >4 y if second-generation TKI DMR duration >2 y if MR4.5 
 DMR duration (MR4 or M4.5) >2 y  

CML, chronic myeloid leukemia; CP, chronic phase; DMR, deep molecular response; IS, internationally standardized; MR4, 4-log molecular response; MR4.5, 4.5-log molecular response; TKI, tyrosine kinase inhibitor.

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