{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T20:04:48Z","timestamp":1776974688625,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,8,27]],"date-time":"2014-08-27T00:00:00Z","timestamp":1409097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Instituto de la salud Carlos III","award":["PI07\/91015"],"award-info":[{"award-number":["PI07\/91015"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:p>In the latest recommendations for the management of chronic\u2010phase chronic myeloid leukemia suboptimal responses have been reclassified as \u201cwarning responses.\u201d In contrast to previous recommendations current guidance advises close monitoring without changing therapy. We have identified 198 patients treated with first\u2010line imatinib, with a warning response after 12 months of treatment (patients with a complete cytogenetic response but no major molecular response [MMR]). One hundred and forty\u2010six patients remained on imatinib, while 52 patients changed treatment to a second generation tyrosine kinase inhibitor (2GTKI). Changing therapy did not correlate with an increase in overall survival or progression\u2010free survival. Nevertheless, a significant improvement was observed in the probability of a MMR: 24% vs. 42% by 12 months and 43% vs. 64% by 24 months (<jats:italic>P<\/jats:italic>\u2009=\u20090.002); as well as the probability of achieving a deep molecular responses (MR<jats:sup>4.5<\/jats:sup>): 1% vs. 17% and 7% vs. 23% by 12 and 24 months, respectively (<jats:italic>P<\/jats:italic>\u2009=\u2009&lt;0.001) .The treatment change to 2GTKI remained safe; however, we have observed a 19% of treatment discontinuation due to side effects. We have observed an improvement of molecular responses after changing treatment to 2GTKI in patients with late suboptimal response treated with imatinib first line. However, these benefits were not correlated with an improvement of progression free survival or overall survival. Am. J. Hematol. 89:E206\u2013E211, 2014. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23816","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T16:59:55Z","timestamp":1406221195000},"source":"Crossref","is-referenced-by-count":7,"title":["Do chronic myeloid leukemia patients with late \u201cwarning\u201d responses benefit from \u201cwatch and wait\u201d or switching therapy to a second generation tyrosine kinase inhibitor?"],"prefix":"10.1002","volume":"89","author":[{"given":"Valentin","family":"Garc\u00eda\u2010Guti\u00e9rrez","sequence":"first","affiliation":[{"name":"Servicio Hematolog\u00eda y Hemoterapia Hospital Universitario Ram\u00f3n y Cajal  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Manuel","family":"Puerta","sequence":"additional","affiliation":[{"name":"Servicio Hematolog\u00eda y Hemoterapia Hospital Universitario Virgen de las Nieves  Granada 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