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European LeukemiaNet Recommendations for the Management of CML

 

Response definitions for any TKI first line - and 2nd line in case of intolerance, all patients (CP, AP, and BC)

http://www.leukemia-net.org/content/leukemias/cml/recommendations/e8078/infoboxContent10432/PocketCard_UPDATE2013_English.pdf

Also

 2015 Apr;94 Suppl 2:S141-7. doi: 10.1007/s00277-015-2322-2. Epub 2015 Mar 27.

A review of the European LeukemiaNet recommendations for the management of CML.

Baccarani M1, Castagnetti F, Gugliotta G, Rosti G.

Abstract
Several guidelines and recommendations on the management of chronic myeloid leukemia (CML) have been prepared by several scientific societies. The European LeukemiaNet (ELN) appointed a panel of experts who submitted their recommendations to peer-reviewed scientific journals in 2006, 2009, and 2013. Here, we make a critical review of the last, 2013, ELN recommendations, concerning the use of the five available tyrosine kinase inhibitors (TKIs), the evaluation of cytogenetic and molecular response, and the strategy of treatment. Three TKIs (imatinib, nilotinib, dasatinib) are recommended first-line. Bosutinib and ponatinib are available second-line; ponatinib is particularly indicated in case of the T315I mutation. Achieving an optimal response, not only for survival but also for a deeper, stable, treatment-free remission, requires a BCR-ABL transcripts level ≤10 % at 3 months, ≤1 % at 6 months, ≤0.1 % at 1 year, and ≤0.01 % later on. Molecular monitoring must include mutational analysis in every case of failure. A successful treatment of accelerated and blastic phase requires TKIs, and in many cases also allogeneic stem cell transplantation.

http://www.ncbi.nlm.nih.gov/pubmed/25814080