Canterbury DHB


Response Definitions, Treatment Goals and Failures

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:

Monitoring and response flow chart

CML monitoring and response flow chart

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

About this Canterbury DHB document (533090):

Document Owner:

Bridgett McDiarmid (see Who's Who)

Last Reviewed:

August 2018

Next Review:

April 2021


Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 533090