Recommendations from the European LeukemiaNet for the Management of CML4
| . | Optimal . | Warning . | Failure . |
|---|---|---|---|
| Baseline | High-risk or CCA/Ph+ (major route) | ||
| 3 mo | BCR/ABL1 <10% and/or Ph+ < 35% | BCR/ABL1 >10% and/or Ph+ 36%-95% | No CHR and/or Ph+ >95% |
| 6 mo | BCR/ABL1 <1% and/or Ph+ 0 | BCR/ABL1 1%-10% and/or Ph+ 1%-35% | BCR/ABL1 >10% and/or Ph+ >35% |
| 12 mo | BCR/ABL1 <0.1% | BCR/ABL1 >0.1%-1% | BCR/ABL1 _1% and/or Ph+ >0 |
| Thereafter, at any time | BCR/ABL1 <0.1% | CCA/Ph− (−7, or del7q) | Loss of CHR; loss of CCyR; *confirmed loss of MMR; mutations; CCA/Ph+ |
| . | Optimal . | Warning . | Failure . |
|---|---|---|---|
| Baseline | High-risk or CCA/Ph+ (major route) | ||
| 3 mo | BCR/ABL1 <10% and/or Ph+ < 35% | BCR/ABL1 >10% and/or Ph+ 36%-95% | No CHR and/or Ph+ >95% |
| 6 mo | BCR/ABL1 <1% and/or Ph+ 0 | BCR/ABL1 1%-10% and/or Ph+ 1%-35% | BCR/ABL1 >10% and/or Ph+ >35% |
| 12 mo | BCR/ABL1 <0.1% | BCR/ABL1 >0.1%-1% | BCR/ABL1 _1% and/or Ph+ >0 |
| Thereafter, at any time | BCR/ABL1 <0.1% | CCA/Ph− (−7, or del7q) | Loss of CHR; loss of CCyR; *confirmed loss of MMR; mutations; CCA/Ph+ |
MMR indicates BCR/ABL1 <0.1%; CCA/Ph+, clonal chromosomal abnormalities in Ph+ cells; CCA/Ph−, clonal chromosomal abnormalities in Ph− cells.
Loss of MMR should be confirmed in 2 consecutive quantitative RT-PCR tests, of which one has a BCR/ABL1 transcripts level >1%.
Monitoring is performed by metaphase cytogenetics on bone marrow aspirate sample and/or by quantitative RT-PCR for BCR/ABL1 transcript levels on blood samples.