The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.

• MeSH
• Survival Analysis MeSH
• Aniline Compounds therapeutic use   MeSH
• Fusion Proteins, bcr-abl antagonists & inhibitors   genetics   metabolism   MeSH
• Quinolines therapeutic use   MeSH
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive diagnosis   drug therapy   genetics   mortality   MeSH
• Dasatinib therapeutic use   MeSH
• Gene Expression MeSH
• Imatinib Mesylate therapeutic use   MeSH
• Protein Kinase Inhibitors therapeutic use   MeSH
• Clinical Decision-Making MeSH
• Consensus Development Conferences as Topic MeSH
• Quality of Life MeSH
• Humans MeSH
• Disease Management MeSH
• Monitoring, Physiologic MeSH
• Life Expectancy trends   MeSH
• Nitriles therapeutic use   MeSH
• Antineoplastic Agents therapeutic use   MeSH
• Pyrimidines therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Aniline Compounds MeSH
• Fusion Proteins, bcr-abl MeSH
• BCR-ABL1 fusion protein, human MeSH Browser
• bosutinib MeSH Browser
• Quinolines MeSH
• Dasatinib MeSH
• Imatinib Mesylate MeSH
• Protein Kinase Inhibitors MeSH
• nilotinib MeSH Browser
• Nitriles MeSH
• Antineoplastic Agents MeSH
• Pyrimidines MeSH