Comparative TFR recommendations
| . | LALNET . | LeukemiaNET . | NCCN . | ESMO . |
|---|---|---|---|---|
| Diagnostic phase | Chronic MANDATORY | Chronic MANDATORY | Chronic | Chronic |
| Type of transcripts | B3a2(e14a2), or b2a2 (e13a2), typic isoform of 210 MANDATORY | Typical e13a2 or e14a2 BCR-ABL transcripts MINIMAL | Quantifiable BCR-ABL transcript | Typical b2a2-or b3a2-BCR-ABL transcripts or atypical transcripts that can be quantified over a 4.5 log dynamic range |
| Sokal Risk | High Sokal Risk patients should be i nformed of the possibility of a higher risk of molecular relapse. Special attention required. | Not mentioned | Not mentioned | Non-high |
| Failure | Only second line due to intolerance MANDATORY | No failure to 1st line MINIMAL | Not mentioned | No failure to 1st line |
| TKI treatment | >5 years for all TKI MANDATORY | > 4 years 2nd GTKI > 5years 1st GTKI MINIMAL | >3 years | >5 years |
| Depth of MR required | MR 4.5 MANDATORY | MR 4.0 (>3 years) MINIMAL MR 4.5 (>2 years) | MR 4.0 | MR 4.5 |
| Duration of DMR | >2 years MANDATORY | >2 years if MR 4.0 MINIMAL >3 years if MR4.0 OPTIMAL >2years if MR4.5 OPTIMAL | >2 years MR 4.0 | >2 years MR 4.0-MR 4.5 |
| Monitoring during TFR phase | Month 1-6 monthly Month 6-12 every 2-3 m Every 3m thereafter | Month 1-6 monthly Month 6-12 every 2 m Every 3m thereafter | Month 1-6 monthly Month 6-12 every 2m Every 3m thereafter | Month 1-6 monthly Month 6-12 every 6 weeks Every 3m thereafter |
| TKI reinitiation | Loss of MMR | Loss of MMR | Loss of MMR. | |
| Other aspects | Results within 2-3 weeks Psychosocial considerations Pharmaco-economic aspects Withdrawal syndrome management | Rapid turnaround results MANDATORY Motivated patient with structured comunication MANDATORY Patients agreement to more frequent monitoring after stopping TKI. MANDATORY | Results within 2 weeks No history AP-BC | Rapid turnaround results within 4 weeks INSTITUTIONAL |
| . | LALNET . | LeukemiaNET . | NCCN . | ESMO . |
|---|---|---|---|---|
| Diagnostic phase | Chronic MANDATORY | Chronic MANDATORY | Chronic | Chronic |
| Type of transcripts | B3a2(e14a2), or b2a2 (e13a2), typic isoform of 210 MANDATORY | Typical e13a2 or e14a2 BCR-ABL transcripts MINIMAL | Quantifiable BCR-ABL transcript | Typical b2a2-or b3a2-BCR-ABL transcripts or atypical transcripts that can be quantified over a 4.5 log dynamic range |
| Sokal Risk | High Sokal Risk patients should be i nformed of the possibility of a higher risk of molecular relapse. Special attention required. | Not mentioned | Not mentioned | Non-high |
| Failure | Only second line due to intolerance MANDATORY | No failure to 1st line MINIMAL | Not mentioned | No failure to 1st line |
| TKI treatment | >5 years for all TKI MANDATORY | > 4 years 2nd GTKI > 5years 1st GTKI MINIMAL | >3 years | >5 years |
| Depth of MR required | MR 4.5 MANDATORY | MR 4.0 (>3 years) MINIMAL MR 4.5 (>2 years) | MR 4.0 | MR 4.5 |
| Duration of DMR | >2 years MANDATORY | >2 years if MR 4.0 MINIMAL >3 years if MR4.0 OPTIMAL >2years if MR4.5 OPTIMAL | >2 years MR 4.0 | >2 years MR 4.0-MR 4.5 |
| Monitoring during TFR phase | Month 1-6 monthly Month 6-12 every 2-3 m Every 3m thereafter | Month 1-6 monthly Month 6-12 every 2 m Every 3m thereafter | Month 1-6 monthly Month 6-12 every 2m Every 3m thereafter | Month 1-6 monthly Month 6-12 every 6 weeks Every 3m thereafter |
| TKI reinitiation | Loss of MMR | Loss of MMR | Loss of MMR. | |
| Other aspects | Results within 2-3 weeks Psychosocial considerations Pharmaco-economic aspects Withdrawal syndrome management | Rapid turnaround results MANDATORY Motivated patient with structured comunication MANDATORY Patients agreement to more frequent monitoring after stopping TKI. MANDATORY | Results within 2 weeks No history AP-BC | Rapid turnaround results within 4 weeks INSTITUTIONAL |
MINIMAL: minimal requirement, MANDATORY: mandatory requirement