What are the standard therapeutic milestones achieved following treatment of chronic myelogenous leukemia (CML)?

Updated: May 23, 2021
  • Author: Emmanuel C Besa, MD; Chief Editor: Sara J Grethlein, MD, FACP  more...
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Answer

The standard therapeutic milestones to be achieved are as follows:

  1. At 3 months: complete hematologic response (normal complete blood count and no evidence of extramedullary disease)
  2. At 6 months: minor cytogenetic response (36% to 65% of cells Ph1+)
  3. At 12 months: major cytogenetic response (0% to 35% Ph1+)
  4. At 18 months: complete cytogenetic response (0% Ph1+)

Failure to achieve these milestones should trigger a reassessment of the therapeutic strategy. Most patients with complete cytogenetic response continue to have positive RT-PCR findings, indicating the presence of MRD. Discontinuation of the drug in these patients is usually followed by relapse, suggesting that imatinib fails to eradicate leukemic stem cells in these patients.


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