TO THE EDITOR:

With the increasing adoption of treatment-free remission (TFR) as a goal for patients with chronic myeloid leukemia (CML), rigorous molecular monitoring has been recommended to ensure timely tyrosine kinase inhibitor (TKI) recommencement in the event of molecular relapse. The National Comprehensive Cancer Network (NCCN) has now incorporated TFR into its most recent guidelines, recommending monthly quantitative polymerase chain reaction monitoring of BCR-ABL1 for the first 12 months following TKI discontinuation. Molecular relapse, the trigger to restarting TKI, is currently defined as loss of major molecular response (MMR; BCR-ABL1 ≤ 0.1% International Scale), and predominantly occurs in the first 6 months following TKI cessation.3,4  Delay in detection of molecular relapse may place patients at unnecessary risk of adverse outcomes, such as loss of complete hematological response. At a minimum, it delays the reachievement of...

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