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Deep molecular response in chronic myeloid leukemia

Leukemia volume 30, page 1632 (2016)Cite this article

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The letters from Young et al.,1 and Morley2 raise a number of points of discussion following the publication of the European Treatment and Outcome Study (EUTOS) recommendations for monitoring deep molecular response (DMR) in chronic myeloid leukemia (CML).3 In particular, both letters argue that the actual value measured is likely to be more accurate than our recommendation to assign a nominal value of 3 BCR-ABL1 targets to any replicate for which BCR-ABL1 is detectable at a level of <3 targets.

The context of the EUTOS recommendations are twofold. First, in CML it is conventional to classify patients with DMR as having achieved MR4, MR4.5, MR5 and so on depending on the level of disease detected (or not detected) by reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) and the sensitivity of that particular result as indicated by the number of reference gene transcripts.4, 5 Second, there is considerable interest in defining criteria for safely stopping tyrosine kinase inhibitor (TKI) therapy for selected CML patients, and such criteria are likely to include having achieved a sustained DMR (MR4, MR4.5 or even deeper response) over a defined period of time.

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References

  1. Young SS, Tucker T, Bosdet I, Karsan A . Estimating deep molecular responses in chronic myelogenous leukemia: a Bayesian approach. Leukemia 2016; 30: 1628–1629.

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  2. Morley AA . Reporting results for deep molecular responses in chronic myeloid leukemia. Leukemia 2016.

  3. Cross NCP, White HE, Colomer D, Ehrencrona H, Foroni L, Gottardi E et al. Laboratory recommendations for scoring deep molecular responses following treatment for chronic myeloid leukemia. Leukemia 2015; 29: 999–1003.

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  4. Cross NCP, White HE, Muller MC, Saglio G, Hochhaus A . Standardized definitions of molecular response in chronic myeloid leukemia. Leukemia 2012; 26: 2172–2175.

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  5. Baccarani M, Deininger MW, Rosti G, Hochhaus A, Soverini S, Apperley JF et al. European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood 2013; 122: 872–884.

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Authors and Affiliations

  1. Faculty of Medicine, University of Southampton, Southampton, UK

    N C P Cross

  2. National Genetics Reference Laboratory (Wessex), Salisbury, UK

    N C P Cross

  3. Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany

    A Hochhaus

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  1. N C P Cross
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  2. A Hochhaus
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Correspondence to N C P Cross.

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Cross, N., Hochhaus, A. Deep molecular response in chronic myeloid leukemia. Leukemia 30, 1632 (2016). https://doi.org/10.1038/leu.2016.78

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