the patients with a relatively large slope during dose reduction, almost all of them eventually relapse. By dichotomizing the patients according to their individual slopes, we find that patients with increased slopes (>0.04) have a 60.8-fold (95% CI: 14.4-548.4) increased chance for molecular relapse compared to patients with moderate slopes (Figure 1B). Summary/Conclusion: Our results demonstrate that individual patient response to TKI dose reduction (measured by BCR-ABL1/ABL1 ratio) is a promising strategy to prospectively identify a sub-cohort of patients who will almost certainly relapse after TKI cessation. Based on this information we recommend that those patients stay under continuous TKI treatment. We cannot comment on whether these patients would fare well if they remain on a de-escalated TKI dose, which we have previously shown is a valid treatment alternative (Fassoni A et al., Haematologica 2018) and associated with an improvement in side effects (Clark RE et al., Lancet Haematology 2017). Exclusion of those high-risk patients could increase the proportion of successfully stopped CML patients to about 77%.
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