Canterbury DHB
The aim of therapy is to achieve at least a major molecular response (MMR) within 12 months of starting TKI. The deeper the response the better. Optimal response includes achieving MR4 by 18 months of TKI therapy.
As of July 2018, the ESMO CML guidelines (2017)6 are the most recent that outline:
Indications for TKI mutation analysis
At diagnosis |
AP or BP patients |
During treatment |
No CHR by 3 months |
|
No MCR (Ph+ >35%) or PCR ≥10% by 6 months |
|
No CCR (Ph+ >0%) or PCR ≥1% by 12 months |
|
No MMR (PCR >0.1%) by 18 months |
|
Loss of response |
|
Significant increase in qPCR- 3.5 fold on a single occasion, or >2 fold on 2 occasions (monthly monitoring) and trending upwards |
|
Appearance of clonal chromosomal abnormalities in Ph+ cells as detected by cytogenetics |
|
Progression to AP or BP |
Topic Code: 533090