- O'Brien, Susan;
- Radich, Jerald P;
- Abboud, Camille N;
- Akhtari, Mojtaba;
- Altman, Jessica K;
- Berman, Ellin;
- DeAngelo, Daniel J;
- Deininger, Michael;
- Devine, Steven;
- Fathi, Amir T;
- Gotlib, Jason;
- Jagasia, Madan;
- Kropf, Patricia;
- Moore, Joseph O;
- Pallera, Arnel;
- Pinilla-Ibarz, Javier;
- Reddy, Vishnu Vb;
- Shah, Neil P;
- Smith, B Douglas;
- Snyder, David S;
- Wetzler, Meir;
- Gregory, Kristina;
- Sundar, Hema
The 2014 NCCN Clinical Practice Guidelines in Oncology for Chronic Myelogenous Leukemia recommend quantitative reverse-transcription polymerase chain reaction (QPCR) standardized to International Scale (IS) as the preferred method for monitoring molecular response to tyrosine kinase inhibitor (TKI) therapy. A BCR-ABL1 transcript level of 10% or less (IS) is now included as the response milestone at 3 and 6 months. Change of therapy to an alternate TKI is recommended for patients with BCR-ABL1 transcript levels greater than 10% (IS) at 3 months after primary treatment with imatinib. Continuing the same dose of TKI or switching to an alternate TKI are options for patients with BCR-ABL1 transcript levels greater than 10% (IS) at 3 months after primary treatment with dasatinib or nilotinib. The guidelines recommend 6-month evaluation with QPCR (IS) for patients with BCR-ABL1 transcript levels greater than 10% at 3 months. Monitoring with QPCR (IS) every 3 months is recommended for all patients, including those who meet response milestones at 3, 6, 12, and 18 months (BCR-ABL1 transcript level ≤10% [IS] at 3 and 6 months, complete cytogenetic response at 12 and 18 months).