CML: Is it possible to stop taking tablets?

💊 Short answer: Yes, it is possible — but not quickly, not simply, not for everyone, and not always.

☝️❗ Stopping treatment should only be done in centers where high-quality, highly sensitive molecular monitoring is available!

🛑 After discontinuation, about 50% of patients lose their achieved molecular response, but restarting therapy usually restores it in most cases.

⭕ Fluctuations between MMR, MR4, MR4.5, and MR5 are not considered loss of response.

⭕ About 80% of molecular relapses occur within 6–8 months after stopping therapy.

✅ Requirements (most important and optimal) for stopping TKI therapy

⚠️ Mandatory: 🟢 CML must be in the chronic phase (no history of acceleration or blast crisis). 🟢 Molecular monitoring by real-time PCR must be available, with results expressed on the International Scale (IS). 🟢 Possibility of molecular monitoring at least once a month during the first 6 months, every 2 months for the next 6–12 months, and then every 3 months thereafter.

⚠️ Optimal: 🟢 TKI treatment duration more than 5 years. 🟢 Duration of deep molecular response more than 3 years for MR4, or more than 2 years for MR4.5.

🙏 Do not stop treatment on your own, even if you have been in a deep molecular response for a long time.

Myelodysplastic Syndromes (MDS) Living with Chronic Myeloid Leukemia (CML)