Publications

The availability of BCR-ABL tyrosine kinase inhibitors (TKIs) has led to a paradigm shift in the management of chronic myeloid leukemia (CML). Patients with chronic phase CML now lead a normal to a nearly normal life [1, 2]. Therefore, the focus has now shifted to treatment free remission (TFR). In fact, TFR is now considered the “new goal” in the management of CML-CP. The STIM trial [3] was one of the landmark studies evaluating the results of treatment free remission. Since then, several other studies also have evaluated the outcomes of TFR [4,5,6,7]. With the availability of several studies, the European Leukemia Net (ELN) [8] and the National Comprehensive Cancer Network (NCCN) [9] have laid down guidelines for patient selection and monitoring of patients who are candidates for TFR. However, these guidelines are often difficult to follow in clinical practice in low- and middle-income resource-constrained countries. We began a structured TFR program in March 2022 at our centre with more stringent inclusion criteria, but with liberal monitoring (as compared to ELN and NCCN criteria; Table 1 highlights the differences between the ELN guidelines, NCCN guidelines and our program). A prospective database of TFR was maintained. This retrospective analysis of prospectively maintained database evaluates outcomes of patients who were initiated on TFR till 31st December 2023. Data was updated till 31st December 2024. The study was approved by the institutional ethics committee. Given the nature of the study, the requirement for a consent was waived off.