Blood: BCR-ABL1 early dynamics predict the long-term prognostication of CML treatment-free remission.

As treatment without treatment (TFR) quickly becomes the ultimate goal of treatment for chronic myeloid leukemia (CML), it is now necessary to develop new strategies to maximize TFR duration by improving our understanding of its key determining factors.
patients with chronic CML who tried TFR to determine the effect of multiple variables on the likelihood of persistent TFR.
early molecular reaction dynamics were evaluated as a predictor by calculating the time unique to BCR-ABL1 after patients were treated with tyrosine kinase inhibitors (TKI).
, a total of 115 patients tried TFR and followed for at least 12 months.
TFR, defined as the presence of major molecular reactions 12 months after TKI treatment, has a 55% probability.
The time required to halve the BCR-ABL1 value is the strongest independent predictor of persistent TFR: 80% of patients with a halving time of less than 9.35 days (first quarter) compared to only 4% of patients with a half time of more than 21.85 days (4th quarter bit).
e14a2 BCR-ABL1 transcription type and TKI exposure time prior to attempting TFR are also independent predictors of persistent TFR.
, the BCR-ABL1 value detected during the 3 months of TKI treatment was not an independent predictor of persistent TFR.
the start of TKI therapy, the early rapid decline of BCR-ABL1 was also associated with an increased likelihood of achieving TFR eligibility.
the time required to halve BCR-ABL1 after continuous TFR and TKI treatment was validated in a separate database.
, the initial dynamics of this study supporting BCR-ABL1 reduction are critical to predicting long-term prognostics.
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